Ingram Store Signup – CoreCommerce

CoreCommerce Store Signup Form

First Name

Last Name

DBA Company Name

Email Address

Phone Number

Your Store Name

Your store name will be come part of a temporary domain name, e.g. http://yourstorename.corecommerce.com/
Max 13 characters. You may not use symbols in your store's name.

Choose a password

Minimum 8 characters long. We also recommend it contains at least one number and one symbol.

What will your store sell?

I sell to:

CorePayments Pre-MPA

Legal Name

DBA Company Name

DBA Phone Number

Website Name

Physical Address of Business

Address 1

Address 2

City

State

Zip Code

Type of Business:

Federal Tax ID Number

Month and Year Business Started

Description of Products and Services of Business

Estimated Monthly Credit Card Volume

Average Transaction Amount

Home Address of Person Signing Paperwork

Title of Person Signing Paperwork

Full name of Person Signing Paperwork

P.O. Box addresses are NOT accepted.

1a.If you are providing a personal home addresses you will need to provide a valid copy of your driver license, utility bill, bank statement or lease agreement.

Address 1 of Person Signing Paperwork

Address 2 of Person Signing Paperwork

City of Person Signing Paperwork

State of Person Signing Paperwork

Zip Code of Person Signing Paperwork

Phone Number of Person Signing Paperwork

A valid Social Security ID # is required due to regulations in fraud prevention.

1a. If you are signing on behalf of a Business, Corporation, Entity, etc.. your social security will only be used for verification on account signup.

1b. This rule applies only for signors NOT signing the personal guarantee.

SSN of Person Signing Paperwork

Birth Date of Person Signing Paperwork

Bank Account Information

Bank Name

Bank Routing Number

Bank Account Number

I agree to the terms and conditions

**There are some required fields that are not filled out. Please make sure all fields in the form are provided.