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Loop Payments Onboarding
"
*
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Company Info
DBA Name
*
Legal Name
*
Physical Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Email
*
Phone
*
Website
*
Mailing Address
Same as Physical Address
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Entity Type
*
-- Please Choose --
Sole Proprietor
Partnership
Non Profit
Government
Association
Trust
EIN Number
*
State of Incorporation
*
-- Please Choose --
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Main location
*
Store/Office
Tradeshow
Residence
Other
Other Location
*
Credit Card Acceptance
Business Questions
I currently or previously accepted credit cards
I have previously been terminated by risk monitoring
I am currently open for business
My business is Seasonal
Current Provider
*
Seasonal Months Open
*
January
February
March
April
May
June
July
August
September
October
November
December
Termination Details
*
Communication Preferences
Statements Preferences
*
Online Only
Online and Mail
Tax forms preferences
*
Online Only
Online and Mail
Typical Volume Expectations
Annual Volume
*
Average Transaction Amount
*
Highest Expected Transaction Amount
*
% Card Present Transactions
*
% Card NOT Present Transactions
Are products and services provided in the future after purchase?
Yes
Items Sold for Future Delivery
What % of products or services are typically not fulfilled/delivered at the time of purchase?
*
How far in the future are products and services typically provided?
*
1-7 Days
8-14 Days
Other
# of Days
*
Merchant Policies
What is your Return/Refund Policy
*
Enter n/a if used for donations
What Products/Services do you sell
*
Online/Mail/Phone Questionnaire
Percent of Business Sales
*
Percent of Consumer Sales
*
Do you have a retail location?
*
Yes
No
Do you sell a service or products?
*
Services
Products
Description of items sold
*
Enter Donations if you are a non profit
Percent of MAIL transactions
Percent of Online transactions
Percent of Phone transactions
Percent of Card present transactions
Physical Address of Business
*
Same as previous
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
How many chargebacks did you have for the previous year?
*
What was the total dollar amount of those chargebacks?
*
How do you advertise?
Legal Contacts
Signers on the account
Contacts
Name
Percent of Ownership
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