MERCHANT PROCESSING APPLICATION Merchant Information Legal Name of Business DBA(Doing Business As) Business Address City State              Zip   Business Telephone Merchant Email Product/Services Sold Business Start Date (MM/DD/YYYY) Tax Filling Name Federal Tax ID # Ownership Principal's Name Ownership % Title Home Address City State              Zip   Home Telephone / Cell Phone Date of Birth(MM/DD/YYYY) SSN Driver's license No Driver's license State Exp Date (MM/DD/YYYY) Settlement Account Bank Name Routing # Account # Marketing Method MC/VI/DS Monthly Volume      $ Average Sales Amount      $ Amex Monthly Volume            $ Highest Sales Amount        $ Swipe Volume                           % Visa Master Card Discover Amex Equipment / Software CleanMax LaundromMax TailorMax ShoeMax Full Version Standard Version In order for Arbelsoft to procure the lowest possible rates and fees for our merchants, a 2 year agreement is necessary Should the applicant be able to provide a statement from their previous processor, Ignite will meet or beat the rates with a copy of your statement at any time. I hereby authorize : Arbelsoft Inc./Ignite Payments to order a credit report on my behalf. Applicant's Name   Date     Submit