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ACF Iso Questionnaire

Iso Partnership Questionnaire

Company Name:

Physical Address:

City: State: Zip:

Office Phone: Cell Phone:

Federal Tax Id:

Email Address:

Website:

Personal Information for Background Check:

Legal Name:

Date of Birth:

Social Security #:

Citizen of what Country?:

Driver's license Number & State:

Have you ever been convicted of a crime:

If Yes, Please Explain:

Are there any pending or threatened legal proceedings against you or your company?:

If Yes, Please Explain:

Are you contemplating a bankruptcy filing personally or for a business you own?:

If Yes, Please Explain:

Please list additional people that should be updated on your submitted deals:

Name: Email Address:

Who is allowed access to commission Data:

Name: Email Address:

Commissions:

I hereby authorize Advantage Capital Funding (ACF), to Process ACH transactions to the account identified below for the purpose of funding approved merchant advances.

Name of the Account:

Name of Bank:

Routing Number (ABA#):

Account Number (DDA#):

Documents Required for ISO Agreement:

Copy of Driver's License

Copy of Voided Check from account to which you wish to have commission deposited

I hereby represent that all of the above information is true and I understand that making false statements might be considered fraud. By providing the above information, I, the applicant authorize ACF and it's Agent or Assigns to investigate my background, financial condition, and creditworthiness.

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

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August 16, 2021 2:53 pm EDT

ACF Iso Questionnaire Uploaded by Aaron Greenblot - [email protected] IP 47.18.196.94