456 Montgomery Street, STE 200, San Francisco, CA, 94104, US
Tell Us What Solution You're Interested In
Which Plan Are You Interested In?
Tell Us A Little About Yourself
Tell Us About Your Business
How Would You Like To Pay For The Hardware?
I hereby authorize VividPayments, LLC to charge the above account for the hardware selected in Section 1 of this application.
Which Address Would You Like The Hardware Shipped Too?
Tell Us More About Your Business
Is Your Physical Location Address The SAME As Your Corporate Address?
Physical Location Address
Indicate if Classified as:
Tell Us About Your Sales
Do you currently accept Visa/MC/Discover® Network?
How Do You Plan On Accepting Payments? (Use Percentages)
Tell Us More About Your Sales
Who owns product?
Are consumers required to provide a deposit?
Tell Us About Your Ownership
Are there any other Owners that own 25% or more?
Upload Driver's License and Voided Check