Request Electronic Payment Service 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) Business Address 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 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: ☐Card Services Agreement, ☐Merchant Processing Agreement How can I help you? We're here to help and answer any questions. We will respond within few hours. Name: Phone: Email: How can we help you today? ---WebsiteBarcode ScannerHostingSEOAPPElectronic Payment Service Message