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Referral Partner

DBA of Customer

Your Full Name

Your Email

Name of Signer on Account

Copy of Signers Drivers License

Copy of Voided Check or Bank Letter

Upload Informational Application or Contract

Does company process more than $80K per month?

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ONLY IF $80k/month or more, uppload three (3) months CC Processing Statements

Total Annual Volume in Cards

Email of Signer on Account

Please describe what this business does

Opportunity in US dollars or Canadian? *

Special Notes

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Do the cc statements attached show this customer using CardConnect?