Use the Checklist below to confirm
**Check off each item and send each as a separate PDF in one Zip File
Due Diligence Documents Needed
3 MONTHS PERSONAL BANK STATEMENTS (IF NEW BUSINESS)
3 MONTHS PROCESSING STATEMENTS FOR ALL ACCOUNTS IF CURRENTLY PROCESSING or
DRIVER LICENSE FOR ALL OWNERS / PRINCIPAL SIGNERS
ARTICLES OF INCORPORATION / LLC
EIN LETTER FROM IRS
CURRENT UTILITY BILL WITH BUSINESS ADDRESS
PROOF OF DOMAIN OWNERSHIP
IMPRINTED VOIDED CHECK OR BANK LETTER ON BANK LETTERHEAD, SIGNED, DATED WITH ROUTING NUMBER, ACCOUNT NUMBER AND COMPANY NAME
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URL / WEBSITE MUST HAVE FOLLOWING LISTED:
PRIVACY POLICY
REFUND POLICY
T
ERMS & CONDITIONS
WEBSIT
E
MUST BE COMPLETE AND PUBLISHED
RETURN POLICY
If Application to Sell CBD then Provide additional information and Documents
DISCLAIMER FOR “NO THC” OR “xx.xx% OF THC CONTENT OR LESS
COA (CERTIFICATE OF ANALYSIS) FOR EVERY PRODUCT SOLD ONLINE. ALSO KNOWN AS LAB (IF CBD) RESULT/TEST
EXPORT OF ALL PRODUCTS SOLD ON THE WEBSITE (EXCEL/CSV FORMAT IS ACCEPTED)
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COMPANY INFORMATION
Legal Name of Business
Legal Address
*
Number of Locations
City
State
Zip Code
Business Email
example@example.com
Customer Svc Phone
DBA Name
Website
DBA Address*
*
City
State
ZIP Code
Contact Phone
Fed Tax ID
Business Start Date
/
Month
/
Day
Year
Date
Type of Corporation
Sole Proprietorship
LLC/LLP
C Corp
S Corp (Partnership)
Government
501C (Check O ne)
Type of Corporation
Currently Accept Cards: Y / N
*Address Registered w/ Secretary of State **Location of Business Operations
OWNERSHIP INFORMATION
Name
Email
example@example.com
Date of birth
/
Month
/
Day
Year
Date
SSN
% of Ownership
*
DL #/State
Home Address
City
State
ZIP Code
Phone
Title
*Info Required for ALL 25% + Owners . See Additional Fields Below
CREDIT CARD PROCESSING INFORMATION
Card Present %
Card Not Present %
Card Swiped %
Internet %
Mail/Phone Oder %
B2B %
Monthly CC Volume
Monthly Amex Volume
Monthly Amex Volume
PIN DEBIT: Y
N
Personal Guarantor: Y
N
Average Ticket
Max High End Ticket
Products/Services Sold
Return/Refund Policy
Product Received %
% 1-7 Days
% 8-14 Days
% 15-30 Days
% 30+ Days
(Must Equal 100% )
Bank Name
Routing #
Account #
EQUIPMENT / SITE INFORMATION
Discount: Daily
Monthly
Gateway / Virtual Terminal
Gateway / Virtual Terminal
Batch: Auto
Manual (Check One)Auto Batch Time:
Manual (Check One)Auto Batch Time
3PL Fulfillment
Y
N
Where is Product Stored
Time Zone
POS System/Gateway/Terminal/PinPad
Fulfillment Name/Address (if applicable)
FLAT RATE PRICING/FEES (FOR AGENT USE ONLY)
Type a question
Cash Discount - 4%
Flat Rate Pricing - 2.95%
Auth Fee per Transaction
ANNUAL Fee
BENEFICIAL OWNER (#2)
Name
Email
example@example.com
Date of Birth
/
Month
/
Day
Year
Date
SSN
DL# / State
Address
City
State
Zip Code
Phone
% of Ownership
Title
BENEFICIAL OWNER (#3)
Name
Email
example@example.com
Date of birth
/
Month
/
Day
Year
Date
SSN
DL# / State
Address
City
State
ZIP Code
Phone
% of Ownership
Title
BENEFICIAL OWNER (#4)
Name
Email
example@example.com
Date of Birth
/
Month
/
Day
Year
Date
SSN
DL# / State
Address
City
State
Zip Code
Phone
% of Ownership
Title
CONTROLLER
Name
Email
example@example.com
Date of Birth
/
Month
/
Day
Year
Date
SSN
DL#/State
Address
City
State
Zip Code
Phone
% of Ownership
Title
Signature of Submitter
Date
-
Month
-
Day
Year
Date
iPOP Agent
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