Signup for CorePayments Now! Fill out the application below to apply for your merchant account with CorePayments! Business InformationAll information provided on this page is confidential and processed internally by our in-house team.I sell:*Please SelectB2B - Business-to-BusineesB2C - Business-to-ConsumerBoth B2B and B2CDo you Dropship as part of your business?*Please SelectNoYesLegal Name of Business* DBA Business Name* *Doing Business AsDBA Phone Number* Physical Address of BusinessAddress 1* Please enter your business' street address. PO Boxes are not allowed on the application. Address 2 City* Country*United StatesCanadaState*Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingProvince*Please SelectAlbertaBritish ColumbiaManitobaNanavutNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanYukonZip Code* Type of Business*Please SelectC Corporation Closely HeldC Corporation Private CompanyC Corporation Public CompanyEstateGeneral PartnershipGovernmentLLCLimited PartnershipSole Prop.Sub S Corp.Tax Exempt OrganizationTrustUnincorporated Assoc.Federal Tax ID Number* Month and Year Business Started* MM slash DD slash YYYY Description of Products and Services of BusinessEmail* Estimated Monthly Credit Card Volume*Average Transaction Amount*Home Address of Person Signing PaperworkTitle of Person Signing Paperwork*OwnerCEOCFODirectorGeneral ManagerAuthorized SignorPresidentVice PresidentTreasurerOtherIf Other, please describe 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* Please enter your business' street address. PO Boxes are not allowed on the application. Address 2 of Person Signing Paperwork City of Person Signing Paperwork* Country of Person Signing Paperwork*United StatesCanadaState of Person Signing Paperwork*Please Select*InternationalAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingProvince of Person Signing Paperwork*Please SelectAlbertaBritish ColumbiaManitobaNanavutNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanYukonZip 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 Number of Person Signing Paperwork* Birth Date of Person Signing Paperwork* MM slash DD slash YYYY Bank Account InformationBank Name* Bank Routing Number* Bank Account Number* CommentsUpload Files Drop files here or Select files Accepted file types: jpg, png, xlsx, csv, pdf, zip, Max. file size: 50 MB. CAPTCHA
