Fillable Attached Document Required For All Business Types Attached

Fill Online, Printable, Fillable, Blank Attached Document Required For All Business Types Attached Form

Use Fill to complete blank online OTHERS pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Attached Document Required For All Business Types Attached

On average this form takes 13 minutes to complete

The Attached Document Required For All Business Types Attached form is 2 pages long and contains:

  • 0 signatures
  • 32 check-boxes
  • 38 other fields

Country of origin: OTHERS
File type: PDF

BROWSE OTHERS FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Check 21 Merchant Application
Business Name:
Contact Name:
Phone:
Email:
Attached Document Required For All Business Types
☐
Signed copy of Merchant Application.
Attached Documents Required For Privately Owned Businesses
☐
Scanned copy of Owners Driver’s License.
☐ Scanned copy of either of the following: ☐ Credit Card ☐ Passport ☐ Other
☐
Certificate of Incorporation.
☐
Fictitious Name Filing/DBA (If applicable).
☐
Utility Bill.
☐
Last three (3) months operating business account statements. (If new business, please provide bank letter)
☐
Last three (3) months ACH/Check 21/Credit Card processing statements. (If available)
☐
Voided check.
Attached Document Required For Telemarketing Businesses
☐
Fulfillment Information and/or Sales script.
IMPORTANT INFORMATION ABOUT OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, Federal law (Patriot Act) requires all
financial institutions to obtain, verify, and record information that identifies each person who opens an account. Identity
verification also helps to protect you and us from fraud. Applications will not be processed until all documents are received.
Email completed application package to your sales representative or to Sales@Check21.com
Sales Representative:
Business Information
Business Name:
DBA:
Site URL:
Address:
City:
State:
Zip:
Business Profile
Business Type:
☐
Sole Proprietorship
☐
Corporation
☐
Partnership
☐
LLC
☐
Government
☐
501C
Publically Traded:
☐
Yes
☐
No
Federal Tax ID:
Corporate URL:
Ownership Information (Required if privately owned)
Business Ownership %:
First Name:
Last Name:
Address:
City:
State:
Zip:
Phone Number:
Email:
Date of Birth:
Social Security #:
Check Processing and Verification
Service(s) Desired:
☐
Virtual Check 21
☐
ATM-NCN Verification
☐
Live Verification
☐
Salesforce RDC
Are You Currently Processing Checks?
☐
Yes
☐
No
Daily Check Volume (Count):
Average Transaction Amount ($):
Return Ratio:
Unauthorized Return Ratio:
Website Information (Required if selling online)
Site URL:
E-Commerce Platform:
Customer Service Phone #:
Subscription Based Business Model:
☐
Yes
☐
No
Type of Marketing Utilized:
☐
Radio
☐
TV
☐
Digital Marketing
☐
Newspaper/Magazine
☐
Other
Terms
By signing below, it is understood that Check21.com, LLC will receive, collect and hold personal or non-public
information about the merchant including but not limited to the merchants name, address, telephone number, e-mail
address, social security number and/or tax identification number, credit history, and criminal record for the purpose of
considering eligibility for the Check21.com, LLC Services. Check21.com LLC may also submit such information to banking
institutions that may be utilized in the processing of Check 21 or Credit Card transactions for the merchant.
By: _____________________________________
Name: __________________________________
Title: ________________ Date: _____________
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Attached Document Required For All Business Types Attached

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 15 December 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document