Allied Wallet TEST FORMhashtags? Merchant Services Application Company Company DBA (doing business as) / trading name:* Legal business name:* Tax/VAT ID number (optional):* Business Telephone Number* Country of Incorporation or Organization* Email Address* Skype / IM address (optional) Customer service phone number* Date business established* Business Street Address:* City* Country* Postcode* Business Mailing Address* City* Country* Postcode* Type of business* Sole Trader/Individual Partnership Corporation Nonprofit Operating from* Office suite Retail storefront Warehouse Private Sector Website Details Important: We NEED to be able to login to your website as a client to approve applications. Your Website URL* Industry* Description of Products/Services* Username* Password* Ownership Please list ALL owners. Total MUST equal 100% ownership Owner 1 name* % ownership* Owner since* Current address* City* Country* Postcode* Previous Address* City* Country* Postcode* Social Security # Mobile Phone #* Date of Birth* Personal email address* Driver License #* Passport #* Passport country of issue* Owner 2 name % ownership Owner since Current address City Country Postcode Social Security # Mobile phone # Date of Birth Personal email address Driver License # Passport # Passport country of issue Additional Information (optional) Terms Payout Schedule Allied Wallet wires every Wednesday to all Merchants due more than 1000 units of the processed and settled currency. Funds will post to the wired account within 1 to 4 business days (bank holidays and country specific holidays may delay funds). Price display: the customer must be able to identify the final price of a product unmistakably. All Merchants must put the Allied Wallet logo and Allied Wallet details for customers to clearly see who they will be billed by on payment pages – Allied Wallet technical team will send you details. This must be done prior to your first payout. Processing Estimated Monthly Volume* Average Ticket Amount (average price of the product or service)* Highest Ticket Amount (highest price of the product or service)* Have you accepted credit card on this website before?* Yes No If yes, name of current/former processor Account/Merchant ID # Years with this processor Have you EVER been blacklisted or had an account closed by MasterCard/Visa or ACH processor?* Yes No Required processing currencies* Required settlement currencies* Do you require MOTO (Virtual Terminal, ie phone orders)?* Yes No If yes, % of sales via MOTO % via online Credit Card Required Card Brands Visa MasterCard Maestro Diners Club Discover JCB China UnionPay Integration Are you offering memberships on your website?* Yes No Do you have a shopping cart?* WebBoss How did you hear about Allied Wallet ? Required Documents Two (2) different forms of Photo Identification. Color copy of current Passport, driver’s license, Government Issued Identification, of owner(s) / signatory(ies) Photo ID #1 Photo ID #2 Past 3 months processing statements* Past 3 months bank statements* Corporate documents: Copy of Articles of Incorporation (or equivalent). If DBA, please furnish DBA filing. If not available, a copy of your business license may be considered an acceptable substitute.* Most Recent Utility Bill showing proof of Legal Business Address* Most Recent Utility Bill showing proof of Home Address for all members/shareholders of the company* Most Recent Utility Bill showing proof of Home Address for all members/shareholders of the company* Business Plan for start-up/new business Business License IF required by law or for specific industries (i.e. ForEx, Gaming, etc.) AUTHORIZATION & ACKNOWLEDGEMENT As part of my application, the company may obtain commercial credit bureau reports on applicant companies. In some instances, additional information about principals of the applicant company may be required, and the company will then obtain a consumer credit report on the Principal(s) identified in this application, The Principals' signatures are therefore required below. I certify that the above information is true and correct, to the best of my knowledge. I hereby authorize, without reservation, the company or an agent acting on its behalf to procure information from various federal, state and other agencies which maintain public and non-public records concerning my past activities relating to my driving, credit, civil, education, employment and other experiences. This report may be compiled with information from but not limited to credit bureaus, court record repositories, military records, department of motor vehicles, past or present employers and educational institutions, governmental occupational licensing or registration entities, business or personal references, any public domain, insurance company, and any other source required to verify information that I have voluntarily supplied for the purpose of verifying my financial standing and credit worthiness. Print Principal Name* Date* If you are a human, do not fill in this field. By submitting this form, your data will be sent via email. For more information, check our Privacy Policy I agree Submit Application Processing...
