Digital Wallet Only Legal Name of Business(Required) DBA Name (if different than above) DBA Phone Number(Required) Physical Address of Business(Required) City, State, Zip(Required) Legal Address (if different from above) City, State, Zip Type of Business Federal Tax ID Number(Required) Month and Year Business Started(Required) Email Address(Required) Estimated MONTHLY Credit Card Volume(Required)Average Transaction Amount(Required)Equipment or Point of Sale Needed(Required) Title of Person Signing Paperwork(Required) Full Name of Person Signing Paperwork(Required) Home Address of Person Signing Paperwork(Required) Phone Number of Person Signing Paperwork(Required) Social Security # of Person Signing Paperwork(Required) Birthdate of Person Signing Paperwork(Required) Name of Bank funds will be credited/debited(Required) Bank Account #(Required) Bank Routing #(Required) Referral Source Digital Wallet(Required) I am signing up for a digital wallet only
