SquarePay - Merchant Account Application

Business Information

Tell us about your business entity

Legal Business Name *

Business name is required

DBA (Doing Business As)

Federal Tax ID / EIN *

Tax ID is required

Business Type *

Please select a business type

Industry / MCC Code *

Please select an industry

Years in Business *

Years in business is required

Business Phone *

Business phone is required

Business Email *

Valid email is required

Website URL

State of Incorporation

Business Address

Street Address *

Address is required

City *

City is required

State *

State is required

ZIP Code *

ZIP code is required

Country

Owner / Principal Information

Details of the primary owner or authorized signer

First Name *

First name is required

Last Name *

Last name is required

Title / Position *

Title is required

Ownership Percentage *

Ownership % is required (1-100)

Social Security Number *

SSN is required

Date of Birth *

Date of birth is required

Phone Number *

Phone number is required

Email Address *

Valid email is required

Driver's License # *

DL number is required

DL State

Home Address

Street Address *

Home address is required

City *

City is required

State *

State is required

ZIP Code *

ZIP is required

Processing Information

Details about your anticipated transaction volumes

Monthly Processing Volume *

Monthly volume is required

Average Ticket Size *

Average ticket is required

Highest Ticket Amount *

Highest ticket is required

Annual Revenue

Current Processor

Reason for Switching

Sales Method Breakdown (must total 100%)

Card Present (Swiped/Dipped)

Card Not Present (Keyed)

E-Commerce (Online)

Total: 0%

Additional Details

Do you accept refunds?

Refund Policy

Products / Services Description

Bank Account & Documents

Settlement account details and required uploads

Bank Account for Deposits

Bank Name *

Bank name is required

Account Type *

Account type is required

Routing Number *

Routing number is required

Account Number *

Account number is required

Required Documents

Voided Check *

PDF, JPG or PNG — Max 10MB

Business License

PDF, JPG or PNG — Max 10MB

Government ID (Front) *

PDF, JPG or PNG — Max 10MB

Government ID (Back) *

PDF, JPG or PNG — Max 10MB

Bank Statements (3 months)

Multiple files allowed — Max 10MB each

Processing Statements

Multiple files allowed — Max 10MB each

Electronic Signature

Sign below to authorize this application

Review & Submit

Please verify all information before submitting

Terms & Conditions

By submitting this application, I certify that the information provided is true and accurate to the best of my knowledge. I authorize the company to obtain credit reports and verify the information supplied. I understand that providing false information may result in denial of the application and possible legal action.

I agree to comply with all applicable card brand rules, regulations, and operating guidelines. I understand that approval of this application is subject to underwriting review and the company reserves the right to decline any application.

I acknowledge that I have read, understand, and agree to the Merchant Processing Agreement, Fee Schedule, and Program Guide. I authorize debits and credits to the bank account listed in this application for processing fees, chargebacks, and other adjustments as outlined in the agreement.

I consent to receive electronic communications regarding my merchant account, including but not limited to account updates, rate changes, and regulatory notices.

I have read and agree to the Terms & Conditions, Merchant Processing Agreement, and Privacy Policy.

Application Submitted!

Your merchant account application has been received. You'll receive a confirmation email shortly.

DGT-000000

Our underwriting team will review your application within 1-2 business days. We'll contact you if additional information is needed.

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