Services
Who We Help
Resources
About Us
Contact
Gateway Login
Apply Now
Page
Quick App
Quick App
[us_separator size=”small”]
14
%
Corporate Legal Info
Company Name
Mailing Address
Physical Location Address
Primary Contact Name
Primary Contact Email
Primary Contact Phone
EIN Tax ID#
Date Business Started
State of Organization
Please select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
# Owners having 25% or more ownership
*
Please select
1
2
3
4
Next
Product / Service Info
Product / Services Sold
Website/URL
Descriptor (21 digits)
Customer Service Phone Number
Customer Service Email
Average Transaction Amount $
Max Transaction Amount $
Offer (Trial / Straight Sale / Subscription/ Retail)
Back
Next
Ownership Info #1
Name
Home Address
How long at current residence
Own or Rent/Lease
Please select
Own
Rent/Lease
Home Phone (MUST not be a virtual #)
Owner Email
Social Security#
% Ownership
Owner’s Title
Driver’s License# & State
Date of Birth
Back
Next
Ownership Info #2
Name
Home Address
How long at current residence
Own or Rent/Lease
Please select
Own
Rent/Lease
Home Phone (MUST not be a virtual #)
Owner Email
Social Security#
% Ownership
Owner’s Title
Driver’s License# & State
Date of Birth
Back
Next
Ownership Info #3
Name
Home Address
How long at current residence
Own or Rent/Lease
Please select
Own
Rent/Lease
Home Phone (MUST not be a virtual #)
Owner Email
Social Security#
% Ownership
Owner’s Title
Driver’s License# & State
Date of Birth
Back
Next
Ownership Info #4
Name
Home Address
How long at current residence
Own or Rent/Lease
Please select
Own
Rent/Lease
Home Phone (MUST not be a virtual #)
Owner Email
Social Security#
% Ownership
Owner’s Title
Driver’s License# & State
Date of Birth
Back
Next
Standard Items Needed
Color copy of Driver’s License of Signing Officer(s)
Articles of Incorporation / Organization
SS-4 Form (letter from IRS verifying the Tax ID #)
Voided Business Check (no temporary checks, must be pre-printed check in the legal company name) OR Signed Bank Account Verification Letter (on bank letterhead & must confirm Company Name, bank acct #, routing # and be signed by Bank Representative)
Business Email
*
Back
Send