Merchant application

Business information

The legal details exactly as they appear on your formation documents.

Legal business name *

This field is required

DBA / trading name

This field is required

Street address *

This field is required

City *

This field is required

State *

This field is required

ZIP code *

This field is required

EIN *9 digits

This field is required

Entity type *

This field is required

Industry *

This field is required

MCCset by underwriting

This field is required

State of incorporation

This field is required

Date business started

This field is required

Years in business

This field is required

Website

This field is required

Business email *

This field is required

Business phone *

This field is required

Referred by If an agent sent you here, enter their name or agent code (for example AG-0007). Leave blank if you came to us directly.

This field is required

Ownership and control

The bank must identify everyone who owns 25% or more of the business.

Full legal name *

This field is required

Title

This field is required

Ownership % *

This field is required

Date of birth *

This field is required

Email *

This field is required

Phone *

This field is required

Social security number *9 digits, stored encrypted

This field is required

Home address

Street address *

This field is required

City *

This field is required

State *

This field is required

ZIP code *

This field is required

Identification

ID type *

This field is required

ID number *

This field is required

Issuing state

This field is required

Expiry date

This field is required

Photo ID — front

This field is required

Photo ID — back

This field is required

Banking

Where your deposits land.

Routing number *9 digits

This field is required

Account number *

This field is required

Name on the account *

This field is required

Account holder *

This field is required

Account type *

This field is required

What is this account used for?

Deposits and debits (both)Deposits only (credits)Debits only

Please choose an option

Proof of account

Voided cheque

This field is required

Bank letterif you have no cheques

This field is required

Processing

What you expect to run through the account.

Monthly card volume *

This field is required

Average ticket *

This field is required

Highest expected ticket

This field is required

Are you taking card payments today?

YesNo

Please choose an option

How you sell

Underwriting prices risk from how and when the customer gets what they paid for.

What do you sell? *

This field is required

How do you take payment?

Delivery and fulfilment

How long after payment does the customer receive it? *

This field is required

Countries you sell to

This field is required

Refund and return policy *

This field is required

What do you need from us?

Documents

Upload what you have. Anything missing can follow by email.

Business licenceif your trade needs one

This field is required

Business bank statements *last three monthsThree months from the account your deposits will land in. Select several at once.

This field is required

Personal bank statementsonly if askedThree months is usual. Select several at once.

This field is required

Marketing materiala menu, price list or screenshotA menu, price list, screenshots — as many as you like.

This field is required

Accepted formats: PDF, JPG, PNG, WEBP, HEIC. Up to 8MB per file. Uploads are stored outside the public web server and are only readable from our back office.

Review and submit

Check everything below. Use Edit on any section to change it — you will come straight back here.

By submitting you confirm the information is accurate and complete, and you authorise VOXEPAY LLC and its partner acquiring banks and processors to review this application and obtain credit reports on the owners listed.

Merchant account application

Business information

Ownership and control

Home address

Identification

Second owner or controlling person

Banking

What is this account used for?

Proof of account

Processing

Are you taking card payments today?

Has a processor ever closed or terminated your account?

Have you applied to another processor in the last 90 days?

How you sell

How do you take payment?

Delivery and fulfilment

What do you need from us?

Documents

Review and submit