Merchant Application > Summit National Advisors

Business Name *

DBA

Entity Type

Sole Proprietor
Partnership
Corporation
LLC

Years In Business

EIN / TID *

Business Phone *

Company Email Address *

Business Address *

Address Line 1

Address Line 2

City

State

Zip Code

Bank Routing Number

Account Number

Website / URL

Average Ticket

High Ticket

Monthly Average Processing

Business Owner- Full Name *

Cell Phone *

Date Of Birth *

Social Sec. #

Ownership Percentage %

Drivers Lic. # *

Photo Copy of Driver's ID *

Click or drag a file to this area to upload.

Frontside Only

State Of Issue *

Home Address *

Address Line 1

Address Line 2

City

State

Zip Code

(if applicable) Business Owner #2 - Full Name

Date Of Birth *

Social Sec. #

Ownership Percentage %

Drivers Lic. #

State Of Issue *

Home Address *

Address Line 1

Address Line 2

City

State

Zip Code

(3) Months Bank Statements + (3) Months Merchant Processing Statements [Upload Here]

Click or drag files to this area to upload. You can upload up to 6 files.

Document Total (6) 3 Bank Statements & 3 Merchant Processing Statements

*Contact Name- (if different from owner)

First

Last

*Email- (if different from business)

SNA Advisor *

First

Last