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1 similar Merchant Services Application and Agreement contracts
MERCHANT SERVICES APPLICATION AND AGREEMENTMerchant Services Application and Agreement • July 12th, 2013 • Nevada
GENERAL BUSINESS INFORMATION Merchant Name (DBA or Trade Name): Corporate/Legal Name (if different): Physical/Location Address: Corporate Address (if different): City: State: Zip: City: State: Zip: Business Telephone: Business Facsimile: Website: Date Business Formed: Years in Business: Months: Start-Up/New Company Federal Tax ID (or SSN if an individual): Number of Locations: Contact Name: Contact Email: Contact Telephone: Contact Facsimile: TYPE OF BUSINESS Sole Proprietorship Corporation (Attach Articles) LLC (Attach Articles) Partnership Publicly Traded -- Stock Symbol: Government Entity (Attach Articles & Tax Determination Letter) Non-Profit (Attach Articles & Tax Determination Letter) Foreign Entity -- Describe: Domestic Registration Yes No If Yes, State: Other: Are you a Franchisee? Yes No If Yes, Franchise Name That Will Be Utilized (Please Attach Franchise Agreement): OWNERSHIP (If a Privately Held Entity - Must Meet or Exceed 51% Ownership) (If a Non-Profit, Publicly Tr
