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This page contains a checklist of information you will need to have ready for the Authorize.Net and SecureSource
Integrated Payment Service application process. Once you have gathered this information and are ready to begin,
please click here to begin the application!
OWNER INFORMATION:
- First, Middle, Last Name
- Date of Birth
- Social Security Number
- Driver's License Number
- Driver's License State
- Home Address Street
- Home Address City, State, Zip
- Home Phone Number
- Email Address
BUSINESS INFORMATION:
- Business Legal Name
- Doing Business As (DBA) Name
(This is the name that will show on your buyers' credit card statements)
- Business Address Street
- Business Address City, State, Zip (only US-based businesses can apply)
- Business Phone / Fax
- Website URL (if applicable)
- Tax ID Number (FEIN)
- Business Start Date
- Type of Ownership:
- Sole Proprietorship
- Partnership
- Corporation
- Non-Profit
- Limited Liability Company
- Government
- Description of Products Sold
- Industry Type (selectable from a list)
BUSINESS PRACTISES:
- Estimated Monthly Credit Card Sales
- Typical Transaction Amount
- Number of Days to Deliver Product or Service
BANK ACCOUNT INFORMATION:
- Bank Name
- 9-Digit Bank Routing Number
- Bank Account Number
- Bank Account Type:
- Business Name on Bank Account
- First, Middle, Last Name of Principal Account Holder
- Billing Address for Bank Account Holder
- Residence
- Business
- Neither
If you have any questions regarding the Electronic Seller Enrollment application process, or would like to contact
us for any other reason at all, please click here.
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