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Application Form

About This Form

This Application Form asks for information that is needed for most applicants. Some of the questions may not apply to you – so just skip them and answer as many as you can. If you have any questions about this form – we can help. Give us a call at 888-616-6967. We’re happy to help and want to ensure that you Feel Good that youve made the best decision for your business.

Application

Please complete all fields which are applicable to your business - note - some may not apply.

1. Business Owner / Director(s)

List all owners of 25% interest in the business or more.
The number of owners must be sufficient to represent more than 50% ownership of the business. -
If this is a Corporation or Non-profit or Charity list the authorized signing officer(s) or director(s).
Based on the description above, how many owners / directors are there?

2. Number Of Owners or DIrectors

You must input a number here in order for the rest of the form to display.

Note: you must provide the following information for each of the Owners (representing more than 50% ownership) or Directors of your Business or Non - Profit

3. Owner's/Director's Legal Name:

4. Position:

Owner

Director

Authorized Signing Officer

5. Owner's/Director's Personal Email Address:

Note: Your Application will be sent to this email address for electronic signature

6. Home Phone Number:

7. Cell Phone number:

8. Home Address:

Street Number and Name:

Unit/Office Number:

City / Town:

Province:

Postal Code:

9. Owner's/Director's Date of Birth:

10. Owner's/Director's SIN (optional):

Owner / Director 2

3. Owner's/Director's Legal Name

4. Position:

Owner

Director

Authorized Signing Officer

5. Owner's/Director's Personal Email Address:

Note: Your Application will be sent to this email address for electronic signature

6. Home Phone Number:

7. Cell Phone number:

8. Home Address:

Street Number and Name:

Unit/Office Number:

City / Town:

Province:

Postal Code:

9. Owner's/Director's Date of Birth:

10. Owner's/Director's SIN (optional):

Owner / Director 3

3. Owner's/Director's Legal Name:

4. Position:

Owner

Director

Authorized Signing Officer

5. Owner's/Director's Personal Email Address:

Note: Your Application will be sent to this email address for electronic signature

6. Home Phone Number:

7. Cell Phone number:

8. Home Address:

Street Number and Name:

Unit/Office Number:

City / Town:

Province:

Postal Code:

9. Owner's/Director's Date of Birth:

10. Owner's/Director's SIN (optional):

Business Information

11. Legal Name of Business:

What is the name of the Sole Proprietor, the Partners, or the Corporation which owns the business.

12. Operating Name of Business:

If your business operates under a different / business name - what is that name?

13. Ownership Type:

Sole Proprietor

Partnership

Corporation

Charity/Non-Profit

Other - If “Other” please explain

Reason

14. Business Type:

Retail

Ecommerce

Services

Other - If “Other” please explain

Reason

15. Business started (month/year):

16. HST/GST number:

Your GST number should look something like this:12345678 RC 0001

17. If Your Are a Charity/Non-Profit we need your CRA number:

18. If You Are a Charity/Non-Profit Attach list of Board of Directors members for Charity/Non-Profit

Please attach this list in the Document Submission Section at the bottom of this form.

19. Business Operation Address:

Street Number and Name:

Unit/Office Number:

City / Town:

Province:

Postal Code:

20. Business Mailing Address:

(if different than the business operation address)

Street Number and Name:

Unit/Office Number:

City / Town:

Province:

Postal Code:

21. Business Phone Number:

22. Customer Service Phone Number:

If you have one

23. Name of Best Contact Person For Your Business

Contact Name

First Last

Contact’s Email Address:

24. Business Website:

25. Social Media Sites, Facebook, Instagram, etc. if you have them:

Facebook:

Instagram:

Twitter:

Other Social Media Accounts (Please specify):

26. Number of Employees:

The following four questions are intended to learn what to expect in your processing transactions. These questions are not intended to limit you.They are designed for the security of your account so that potentially fraudulent transactions are flagged.

27. Approximately how much do you process or expect to process annually?

28. Approximate average transaction amount?

29. Probable highest transaction amount?

30. How often will you process that highest amount?

Please attach a copy of a void cheque or PAC/PAD form at the end of this form.
Note - This should not be a starter cheque (i.e. one without a preprinted name).
You can download your PAD/PAC form from most online banking websites.

Additional Requirements If Applicable To Your Business:

If your business has been operating for less than one year kindly attach the following additional information:

1. Articles of Incorporation or business name registration showing ownership details.
2. Lease and/or utility bills for business location
3. If retail, photos of store – inside and out, showing signage and products
4. Last 3 months’ bank statements
5. Last 3 months’ processing statements

If the business

1) processes over $5 Million annually (other than restaurants without catering) or
2) if it takes payments in advance and processes over $1 Million annually (other than new car dealers) or
3) processes over $1 Million a year and belongs to one of the following industries,

1. Contractors, construction
2. Events, Festivals, Conferences,Theatres
3. Fitness Club or programs
4. Furniture and/or Appliances
5. Programs, courses that last for more than 30 days
6. Travel related (e.g. travel agencies, tour operators).

Then please provide the following:

1. Accountant prepared financial statements for the last two financial year ends,
2. Interim financial statements (if the fiscal year end is more than 6 months earlier),
3. Bank account statements for the past three months, and
4. Processing statements for the past three months

Upload your documents here.

If you have more than 2 documents to upload please place them into a folder, Zip or compress that folder and then upload the Zipped folder.

Max. file size: 1 GB.

If you have difficulties uploading your forms please call 1-888-616-6967.

Max. file size: 1 GB.

If you have difficulties uploading your forms please call 1-888-616-6967.

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