Thanks for your interest in Freedom Merchants.
We have received your information and will be in touch with you shortly.
In the mean time, please fill out the application form below.

 

Sign-up for Effortless Credit-card and Echeck Processing

Please fill out the form below (takes about 5 minutes) to get started with effortless QuickBooks-integrated credit-card and Echeck/ACH processing.
If there's anything you're not sure of, just make your best guess and we can confirm with you afterwards. You'll also get a chance to update any information before you E-sign the Link that we send you.

General Information Icon General Information

Location Country
Name of Account ("DBA" Doing Business As - appears on Receipts)
Location Address
Location City
Currency you wish to Receive Funds in
Location State/Province
Please select a country
Location Zip/Postal Code
Location Type
Click Here only if Billing Address different from Location Address
Location Phone Number
Corporate Office Phone #
Website Address (if you have a Site)
Contact Email Address
Legal Tax Filing Business Name
For Sole-Props, please put your full personal name into the field above.
Corporate Tax ID-# ("FEIN #" or EIN-# or Business-Number BN#)
Primary Contact – First Name
Primary Contact – Last Name
Primary Contact – Title

 

Business Details Business Details

% of Business Swiped (versus Keyed versus Internet)
Describe Goods/Services sold
When are products/services delivered?
Average CC Transaction Size (Approx, digits only please)
Maximum CC Transaction Size (For Now, digits only please)
Estimated Monthly CC $ Volume (digits only please)
Refund Policy
If Policy Other, Which (Max 75 Characters):
Type of Ownership
Approximate Date Started Business (MM/DD/YYYY)
# of Locations

 

# of Owners with Ownership greater than or equal to 25%:

 

Principal Information Icon Principal Information

Principal Owner - First Name
If the company is owned by another company, please put the First/Last Name and related info of the primary and/or effective “Control Owner” of the ultimate corporate structure.
Principal Owner - Last Name
Principal Owner - Email Address (if different from Primary Contact)
% of Company Ownership
Principal Title (Owner, President, Co-Owner, LLC Partner, Exec Director, Other)
Principal Birthdate (mm/dd/yyyy)
Principal SSN (US) /Social Insurance # (Can)
Used to verify US/Canadian Citizenship only. No Hard-pull on Credit-score (except for Sole-Proprietors)
Principal Driver's License #
Principal Driver's License State/Province
Home-based Business?
Home Street Address of Principal
Home City of Principal
Home State/Province of Principal
Home Zip/Postal of Principal
Principal Own/Rent Home
# of Years at Home-Address
Any Prior Personal Bankruptcy (No/Yes)

 

I don't have their information right now but can send it to you separately.

Second Owner Information Icon Second Owner Information

Second Owner - First Name
Second Owner - Last Name
Second Owner - Email Address
Second Owner - % of Company Owned
Second Owner - Title (Owner, President, Co-Owner, LLC Partner, Exec Director, Other)
Second Owner - Birthdate (mm/dd/yyyy)
Second Owner - SSN (US) /Social Insurance # (Can)
Second Owner - Driver's License #
Second Owner - Driver's License State/Province
Second Owner - Home Street Address
Second Owner - Home City
Second Owner - Home State/Province
Second Owner - Home Zip/Postal
Second Owner - Own/Rent Home
Second Owner - # of Years at Home-Address
Second Owner - Any Prior Personal Bankruptcy (No/Yes)

 

I don't have their information right now but can send it to you separately.

Third Owner Information Icon Third Owner Information

Third Owner - First Name
Third Owner - Last Name
Third Owner - % of Company Owned
Third Owner - Title (Owner, President, Co-Owner, LLC Partner, Exec Director, Other)
Third Owner - Birthdate (mm/dd/yyyy)
Third Owner - SSN (US) /Social Insurance # (Can)
Third Owner - Driver's License #
Third Owner - Driver's License State/Province
Third Owner - Home Street Address
Third Owner - Home City
Third Owner - Home State/Province
Third Owner - Home Zip/Postal
Third Owner - Own/Rent Home
Third Owner - # of Years at Home-Address
Third Owner - Any Prior Personal Bankruptcy (No/Yes)

 

I don't have their information right now but can send it to you separately.

Fourth Owner Information Icon Fourth Owner Information

Fourth Owner - First Name
Fourth Owner - Last Name
Fourth Owner - % of Company Owned
Fourth Owner - Title (Owner, President, Co-Owner, LLC Partner, Exec Director, Other)
Fourth Owner - Birthdate (mm/dd/yyyy)
Fourth Owner - SSN (US) /Social Insurance # (Can)
Fourth Owner - Driver's License #
Fourth Owner - Driver's License State/Province
Fourth Owner - Home Street Address
Fourth Owner - Home City
Fourth Owner - Home State/Province
Fourth Owner - Home Zip/Postal
Fourth Owner - Own/Rent Home
Fourth Owner - # of Years at Home-Address
Fourth Owner - Any Prior Personal Bankruptcy (No/Yes)

 

Checking Account Information Icon Checking Account Information

Bank Name
FID # (3 digits)
Routing/Transit Number
Account Number
Re-enter Checking Account Number
Checking account # doesn't match

 

Credit Card Information Icon Credit-Card Information

(for USD$17/month and $0.05/transaction Gateway Fee, only charged if application approved)
Credit Card #
Expiration Date
CVV

 

Additional Information Icon Additional Information

Currently Processing Credit-Cards?
Do you want to accept E-Checks/ACH too?
Estimated Average E-check Transaction Size:
Estimated Maximum E-check Transaction Size:
Estimated Monthly E-check $ Volume:
Do you want to accept American Express?
Existing Amex Merchant # (if applicable)
Accounting Software?
How did you hear about Freedom Merchants?
if Other, please specify:
Who is your Bookkeeper?
How much is:
Answer:
Checking account # doesn't match

Thanks!

We have received your application and we will be in touch shortly.
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