Merchant Application

DBA

Entity Type

Sole Proprietor

Partnership

LLC

Corporation

EIN / TID *

Business Phone *

Company Email Address *

Number of Years in Business

Business Address *

City *

State *

Bank Routing Number

Bank Account Number

Website *

Ticket Average - Price / Sale

High Ticket - Price / Sale

Processing Average /mo.

Business Owner's Full Name *

Cell Phone *

Driver's License # *

Driver's License -copy *

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Social Security Number -Owner 1

Ownership % *

State Issued *

Home Address

Home City

Home State

Zip Code

2nd Owner Full Name

Owner2 -Percentage

Owner2 Driver's License. Number

Social Security Number -Owner 2

Owner2 -Phone Number

Contact Name (If different from Owner)

Email (If different from Business)

Notes

Account Representative *

(3) Months Bank Statements

(3) Months Merchant Processing Statements

I agree to terms & conditions provided by the company.

Merchant Accounts are referred to and processed by North American Bancard, LLC. North American Bancard, LLC is a registered ISO of Wells Fargo Bank, N.A., Concord Ca., The Bancorp Bank, Philadelphia, PA, and BMO Harris N.A., Chicago, IL. American Express may require separate approval.

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Call (480) 400-0782

Email: info@sunwestcapitalgroup.com

Site by: The BICA AGENCY

The Edge Program

Merchant Cash Advance

Hybrid Credit Lines

Receivables & Factoring

Asset-Based Lending

Merchant accounts are referred to and processed by North American Bancard, LLC. North American Bancard, LLC is a registered ISO of Wells Fargo Bank, N.A., Concord Ca., The Bancorp Bank, Philadelphia, PA, and BMO Harris N.A., Chicago, IL. American Express may require separate approval. Data collection is used for underwriting purpose by our partner companies. Your information will not be used or sold by us or any of our partner companies.