Online Application Instructions
1. Be sure you have contacted your Sales Representative prior to completing this application. You will need to place his/her Sales ID on the application.
2. Complete ALL fields of the following application.
3. Once completed, print all pages.
4. Initial the bottom of pages 1 and 2 and sign pages 3 and 4 where indicated.
5. Fax the completed application to your Sales Representative along with any additional documentation.



Please Have The Following Items Ready:

  • Social Security Number
  • Business tax ID (if different from SSN)
  • Business checking account # (DDA)
  • Bank transit and routing number
  • Business name and address
  • Home address
  • Email address
  • Driver's license number
  • Trade reference information
  • Connection to printer (see below)

Please review your product type with your sales representative for compliance with Humboldt Merchant Services' approval criteria.

Get Acrobat Reader

REQUIRED SOFTWARE

  • A connection to a printer. You must print the application when it is complete. You will not be able to save a partially completed application to print later.
  • Adobe Acrobat Reader® version 4.0 or later is required to complete the Application.

Open application now
Download application now