Documents Submission Form

Attach these documents with your application form.

"*" indicates required fields

Company Name*

Same name as on your application.

1. Signed Agent Agreement*

Each Page initialed

Drop files here or

Max. file size: 256 MB.

2. Check Form*

Signed and Dated

Drop files here or

Max. file size: 256 MB.

3. W-9 Form*

Signed and Dated. Do not alter any part of form.

Drop files here or

Max. file size: 256 MB.

4. Driver's License*

Photo Copy

Drop files here or

Max. file size: 256 MB.

5. Voided Check*

Copy

Drop files here or

Max. file size: 256 MB.

6. ACH Authorization Form*

Signed and Dated

Drop files here or

Max. file size: 256 MB.

Upon exexution of this Agreement by Agent Partner and AP, Referral Partner will be assigned their sales ID number(s).