Welcome to First Data Independent Sales

	Merchant Information Legal Name of Business DBA Street address, City, State, Zip Telephone/Fax No. Tax ID No. (if applicable) Years in Business Merchant e-Mail Type of Business ISP/CSP e-Mail
	51% Ownership Required Private Corp. or LLC Principal's Name 100% Ownership Title Date of Birth Social Security No. Driver's License Number w/ expire Street Address, City, State, Zip Home Phone Partner info. if applicable
	Settlement Account Direct Deposit Account (DDA) Bank Name Transit Routing Number DDA Number If Credit Union, Telephone & Contact name needed Marketing Method Average Monthly Volume Average Ticket/Sales Amount Processor Questions Name of Processor
Other Criteria Voided Check Additional Documents Articles of Incorporation/Organization