Payment Solutions Questionnaire | Dotedison

Payment Solutions Questionnaire

The information below is needed to set up a merchant processing account for your business. Filling out the form should take less than 6 minutes.

*All Data is encrypted with AES-256 bank/military-grade database storage encryption

Step 1 of 3

Consent*
I agree for dotedison to open a merchant processing account for my business.
To set up a merchant processing account for credit card processing we will fill out an application for you and you will get the final docusign agreements to sign off on. The below information is secure and will ONLY be used for those purposes.
Business Information
Business Name*
Business Type*
Business Start Date*
MM slash DD slash YYYY
EIN*

Ownership Information
Ownership Percentage*
SSN*
Driver License Number*
Residential Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Bank Information
Bank Name*
Account Type*
Account Usage*
Routing Number*
Account Number*
Average Monthly Number of Transactions*
Average Transaction Amount*
Refund Policy*
Comments
This field is for validation purposes and should be left unchanged.

If you have any questions or ever need to reach us, feel free to give us a call at 205-332-3728 or email our support email at support@dotedison.com.