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.What industry best first your business?*Please SelectAuto/IndustrialCrafts/GiftsElectronicsFashion/ApparelFood/DrinkHealth/BeautyHome Decor/GardenJewelryMusicOtherSports/OutdoorsToys/Kids/BabyI sell:*Please SelectB2B - Business-to-BusineesB2C - Business-to-ConsumerBoth B2B and B2CLegal Name of Business* DBA Business Name* *Doing Business AsDBA Phone Number* Domain Name of Website* Physical Address of BusinessAddress 1* Address 2 City* State*Please Select*InternationalAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZip 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* 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* Address 2 of Person Signing Paperwork City of Person Signing Paperwork* State of Person Signing Paperwork*Please Select*InternationalAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZip 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
