Merchant Onboarding

Initial Questionnaire

Complete the form below. Your representative will receive your information and follow up within one business day.

Business

Owner

Banking

Review

Business Information

Tell us about your business

DBA (Doing Business As) *

Legal Business Name *

Business Address *

City *

State *

ZIP Code *

Business Phone *

Business Email *

Contact Name *

Contact Email *

Federal Tax ID (EIN) *

Business Start Date

Number of Locations

Number of Employees

Business Type

Product / Service Sold *

Owner / Signer Information

Principal owner who will sign the agreement

Full Name *

Title *

Home Address *

City *

State *

ZIP Code *

Home Phone

Mobile Phone

Social Security Number * Transmitted securely — used for identity verification only

Date of Birth *

Banking Information

Where your deposits will be sent

Bank Name *

Bank Contact

Routing Number (ABA) *

Checking Account Number *

Processing Profile

How your business accepts payments

Swiped / Card Present % % of transactions where customer is present

Hand Keyed / Card Not Present % % of transactions keyed manually

Do you accept PIN Debit?

Yes No

Review Your Application

Please confirm everything looks correct before submitting

Business

Owner

Banking & Processing

🔒 Your information is transmitted securely over HTTPS and used solely for the purpose of establishing your merchant processing account. MBI Merchant Solutions will never sell your data.

✓

Application Received

Thank you — your application has been submitted successfully. Your MBI representative will review it and follow up within one business day.

Questions? Call us at (626) 340-4900