PL4V Application

Legal Name of Business(required)

DBA (Doing Business As)

Type of Company (LLC, Corporation, etc…)(required)

Month / Year of Incorporation(required)

State in which Company was Incorporated(required)

IRS Tax Filing Name(required)

Company's Federal IRS Assigned EIN(required)

Physical Address of Your Office(required)

Office Phone Number(required)

Primary Point of Contact's Full Name (for communication only)(required)

Primary Point of Contact's Email (for communication only)(required)

Primary Point of Contact's Phone Number (for communication only)(required)

Name of Company Owner or Officer for the Application, if Differerent than Above

Ownership %

Date of Birth of Company Owner or Officer for the Application(required)

Home Address of Company Owner or Officer for the Application(required)

Phone Number of Company Owner or Officer for the Application (if different than above)

Website (beginning with http://www or https://)(required)

Company's Annual Revenue(required)

Projected Monthly Credit Card Sales(required)

Average Credit Card Ticket (in Dollars)(required)

Highest Credit Card Ticket (in Dollars)(required)

Brief Description of the Products and/or Services Sold by the Company(required)

How do You Accept the Majority of Credit Card Payments Now?

Briefly describe how your company currently accepts payments, what features of PaymentLOCK 4Vets you're most interested in, and anything else you'd like us to know!

Which Package are You Interested In? (It's ok if you're not sure, we'll find the best one together…)

PL4V Application

PaymentLOCK 4Vets Application

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PL4V Application

PaymentLOCK 4Vets Application

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