Business Information




    Legal Address



    DBA Address



    Location


    Time at current residence



    Length of Ownership



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    Personal Information

    Date Of Birth




    Home Address




    Length of location




    ID Type



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    Business Profile

    Please describe in detail the products / services sold ?



    What is the delivery timeframe of goods / services?



    What percentage of sales are shipped or completed outside of 30 days?



    Is there any recurring billing or trial offers as part of the purchase?



    Please detail how the products or services are advertised or marketed? (i.e. website, tv, radio, call center). Please provide a sample of your marketing material (brochure, flyer, order form, advertising script, contracts, or agreements)



    Do you anticipate accepting foreign sales?



    Are products/services fulfilled by a third party?



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    Credit card processing

    Do you currently accept Visa®/MasterCard®/Discover®/American Express®?



    Is your business PCI complaint?



    Need electronic check processing?



    Interested in chargeback prevention & fraud tools?



    How are you taking cards?



    Bank details



    Sales Details




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