MERCHANT INFORMATION
Business Information
* Required
Legal Business Name:
*
Your answer
Trading As (DBA Name)
Your answer
Business Physical Address
*
Your answer
Business Mailing Address
*
Your answer
Type of Goods or Services Sold
*
Your answer
Business Type
*
Individual/Sole Proprietor
Partnership
Option 3
Corporation
Non Profit
Required
If you are a Corporation which type:
*
C
S
LLC
PA
NP
Other:
Required
Age of the Business
*
Your answer
Federal Tax ID
*
Your answer
Business Phone Number
*
Your answer
Business Fax Number
Your answer
Website Address
Your answer
Business Email Address
*
Your answer
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