Merchant Application

1. Business information

Legal business name *

DBA / trade name

Entity type *

Federal EIN / Tax ID last 4

Business website

Industry / business type *

Years in business *

Number of locations

Business address *

City *

State *

ZIP *

Business email *

2. Primary owner / authorized signer

First name *

Last name *

Title *

Ownership % *

Email *

Phone *

Home mailing address

Full SSN, date of birth and identity verification should be collected through the processor or acquiring bank’s secure onboarding portal if required.

3. Current processing profile

Do you currently accept cards? *

Current processor

Average monthly card volume *

Average ticket *

Highest expected ticket

Monthly transaction count

Card-present %

Ecommerce / keyed %

Typical monthly chargebacks

Previous merchant account terminated?

If yes, explain

4. Payment channels & needs

Primary sales channel *

Funding preference

Current POS / gateway / software

Anything else we should know?

5. Certifications & consent

I certify that the information provided is accurate and complete to the best of my knowledge.I authorize TRAK to share this application with prospective processors, acquiring banks, gateways and service providers as reasonably necessary to evaluate payment-processing options.I agree to the website terms and application authorization and understand that final processing is subject to a separate provider agreement and underwriting.I consent to receive electronic communications regarding this application.