Get In Touch DBA NAME LEGAL BUSINESS NAME BUSINESS ADDRESS BUSINESS PHONE NUMBER EIN EMAIL ADDRESS OWNER’S FULL NAME OWNER’S DOB OWNER’S SSN BUSINESS TYPE RETAIL ONLINE RESTAURANT ON THE GO PRODUCTS OR SERVICES SOLD HAVE YOU BEEN TERMINATED BY CARD BRAND? Yes No BANK ACCOUNT NUMBER BANK ACCOUNT ROUTING NUMBER TERMS & CONDITIONS: YOU ARE ALLOWING EZ PAYMENT SYSTEMS TO PROCESS YOUR APPLICATION WITH A PSP. Send Get In Touch DBA NAME LEGAL BUSINESS NAME BUSINESS ADDRESS BUSINESS PHONE NUMBER EIN EMAIL ADDRESS OWNER’S FULL NAME OWNER’S DOB OWNER’S SSN BUSINESS TYPE RETAILONLINERESTAURANTON THE GO PRODUCTSSERVICES SOLD HAVE YOU BEEN TERMINATED BY CARD BRAND? BANK ACCOUNT NUMBER BANK ACCOUNT ROUTING NUMBER TERMS & CONDITIONS: YOU ARE ALLOWING EZ PAYMENT SYSTEMS TO PROCESS YOUR APPLICATION WITH A PSP.