Information For Payment gateway

Company Name *

As Per Registration Documents

Country/State of Incorporation *

EIN No. *

Enter the EIN (Employer Identification Number) of the US Company.

Company Type *

Business Registered Address *

Address Line 1

Address Line 2

City

State

Zip Code

Owner/Responsible Party Name *

First

Last

The name must exactly match the personal identification proof i.e. tax document (PAN/ITIIN/SSN etc) being submitted here.

Owner's Residential Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Owners' current residential address

Owner's Date of Birth *

Owner's Personal Tax ID No. (PAN/ITIN/SSN/SIN etc) *

Owner's Phone No. *

This would be used for account verification through OTPs etc. Make sure that this phone number can receive texts/OTPs in real time. This can be a non-US number also.

Email *

This email would be used for Stripe account sign-up.

Company Website / URL *

An active website is mandatory for Payment Gateway application

Company Support Phone *

Must be a US phone number.

Bank Name: *

Funds from the Payment Gateway will be settled in this account.

Bank Account No. *

Bank Routing No. *

Product/Service Category *

Write briefly about the business type which this gateway would be used for.

Upload Copy of Personal Tax ID *

Click or drag files to this area to upload. You can upload up to 3 files.

Upload a copy of PAN/ITIN/SSN/SIN etc

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