1. Business Owner Personal information:
Legal Name:
Date of Birth:
Home Address:
Last 4 digits of SSN:
I DO Agree
That the business may communicate with me electronically at the email address and/or phone number listed below. By completing this application, I confirm that I am authorized to submit this application and enter into the agreements linked below on behalf of business indicated.
2. Business location & information:
Legal business name / DBA
The combination of your name and EIN must exactly match the one listed on your IRS documents including capitalization and punctuation.
Business Address
Employer Identification Number (EIN)
Business phone number
3. Business Structure:
IndividualSole ProprietorshipsLimited Liability Company ( Single ) ( Multi )Corporations
4. Business Details:
Business type / product (Example: Beauty, Food, Accessory)
Business site URL
5. Business contact information:
Name / Job Title
Phone Number / Mobile (for authorize)
Contact Email (for authorize)
6.Payment Information:
Your statement descriptor shows up on your customers' bank or credit card statements. It should be 5-22 characters.
Statement descriptor
Customer support phone number
Bank details (Bank name & address, Account number, routing number)/ sales tax calculation
7. Payment Card Information:
Your Name on Card
Card Number
Expiration
CVC
Base Service Fee (per month, except solution service fee) ☐ $19.99 (Under 1500 trans) ☐ $39.99 (Over 1500 trans)
By submitting this form, you agree to the Stripe & Yubin Soft Services Agreement, to receiving autodialed text messages from Stripe & Yubin Soft, and you certify that the information provided is complete and correct. Stripe, Inc., is a registered Payment Facilitator and ISO of Cross River Bank, Fort Lee, NJ, PNC Bank, NA, Pittsburgh, PA, and Wells Fargo Bank, NA, Concord, CA. ☐ Card Services Administration Agreement I AGREE, I confirm that I understand and have read each of the linked documents, and the business indicated above agreements to be bound by the terms contained therein: ☐Gateway Service Agreement and Fees , ☐Card Services Agreement, ☐Merchant Processing Agreement
