[Vivid] Vino

Tell Us A Little About Yourself

Full Name:

Email Address:

Phone Number:

Tell Us About Your Business

Legal Business Name:

Doing Business As (DBA):

Type of Ownership:

Date Business Started:

Federal Tax ID Number:

Website:

Is Your Physical Location Address The SAME As Your Corporate Address?

Yes

Bank Name:

Bank Account # (DDA):

Bank Routing # (ABA):

Tell Us About Your Sales

Estimated Monthly Sales Volume

Estimated Average Ticket Amount

Estimated High-End Ticket Amount

How Do You Plan On Accepting Payments? (Use Percentages)

% Store Front/ In-Person

% Phone Order (Keyed)

% E-Commerce

What is your return, cancellation, or refund policy?

Tell Us About Your Ownership

Name

Title

Date of Birth

Social Security Number

Ownership %

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Additional Questions/Comments?