Tilled Merchant App Tilled Merchant App Business Type Business Type * CharityCommunity Interest CompanyCorporationLimitedLimited Liability CompanyLimited Liability PartnershipNon-profitPartnershipPublic CompanyPublic Sector/GovernmentalSole Proprietorship/Sole TraderTrust Business Details Legal Business Name * Business Number * Tax ID#, Canadian Business #, Social Security #, or EIN # Doing Business As (Optional) Enter the business name you present to your customers Date of Incorporation * Business Address * Business Apt #, Suite # Business City * Business State * Business Postal Code * Contact Information Customer Support Phone Number * Customer Support Email * Website/URL * Application Signer Application Signer Name * Application Signer Name First Name First Name Last Name Last Name Job Title * CEOControllerCo-ownerDirectorFinancial OfficerGeneral ManagerGeneral PartnerLimited PartnerManagerMemberOwnerPresidentSecretarySenior Vice PresidentTreasurerVice President Does This Individual Own 25% or More of the Business * YesNo Date of Birth * Social Security Number * Phone Number * Email * Residential Address * This is where the Application Signer Lives Address Apt #, Suite # City * State * Postal Code * Number of Years at Residence * Signers Previous Residential Address This is where the Application Signer Lives Address Apt #, Suite # City State Postal Code Number of Years at Residence Business Owner Information Business Owner * Business Owner First Name First Name Last Name Last Name Job Title * CEOControllerCo-ownerDirectorFinancial OfficerGeneral ManagerGeneral PartnerLimited PartnerManagerMemberOwnerPresidentSecretarySenior Vice PresidentTreasurerVice President Ownership Percentage * Date of Birth * Social Security Number * Phone Number * Email * Residential Address * This is where the Application Signer Lives Address Apt #, Suite # City * State * Postal Code * Number of Years at Residence * Owners Previous Residential Address * This is where the Application Signer Lives Address Apt #, Suite # City State Postal Code Number of Years at Residence Products and Services Industry * 8931 | Accounting/Bookeeping Services4119 | Ambulance Services5970 | Artists Supply and Craft Shops7230 | Barber and Beauty Shops7542 | Car Washes1750 | Carpentry Contractors5811 | Caterers8398 | Charitable and social Service Organizations – Fundraising8351 | Child Care Services8049 | Chiropodists, Podiatrists8041 | Chiropractors7349 | Cleaning and Maintenance8220 | Colleges, Universities4816 | Computer Network Services7372 | Computer Programming7379 | Computer Repair1771 | Concrete Work Contractors7392 | Consulting, Public Relations7997 | Country Clubs8021 | Dentists, Orthodontists5965 | Direct Marketing – Combination Catalog and Retail Merchant8011 | Doctors5812 | Eating Places, Restaurants8299 | Educational Services1731 | Electrical Contractors8211 | Elementary, Secondary Schools5814 | Fast Food Restaurants1520 | General Contractors9399 | Government Services (Not ElseWhere Classified)5411 | Grocery Stores, Supermarkets1711 | Heating, Plumbing, A/C Contractors0780 | Landscaping Services8111 | Legal Services, Attorneys1740 Masonry, Stonework, and plaster Contractors8099 | Medical Services8699 | Membership Organizations5499 | Miscellaneous Food Stores – Convenience Stores5399 | Miscellaneous General Merchandise7299 | Miscellaneous General Services7999 | Miscellaneous Recreation Services7699 | Miscellaneous Repair Shops4214 | Motor Freight And trucking8050 | Nursing/personal Care8043 | Opticians, Eyeglasses8042 | Optometrists, ophthalmologist8031 | Osteopaths7523 | Parking Lots, Garages5044 | Photographic, Photocopy Equipment8999 | Professional Services6513 | Real Estate Agents and Managers – Rentals8661 | Religious Organizations1761 | Roofing. Siding, Sheet Metal Contractors1799 | Special Trade Services7032 | Sporting Recreation Camps4121 | Taxicabs/Limousines7922 | Theatrical Ticket Agencies4900 | Utilities0742 | Veterinary Services8249 | Vocational/Trade Schools Describe Your Product or Services * Fulfillment Timeframe * Immediately1-2 Days3-30 Days31-60 Days61-90 Days90 or More Days Refund Period * Same Day2-7 Days7-30 Days31-60 Days61-90 Days90 or More Days How long is the refund policy applicable after the transaction Are more than 50% Of your company’s sales made directly to other businesses (B2B) * YesNo Payment Acceptance Previous Payment Processor * Statement Descriptor * Enter how you want your business name to appear on the customers statements Processing Volumes Number of Transactions Per Month * Monthly Processing Volume $ * High Ticket Amount $ * Single Sale High Range Credit Card - Average Transaction Amount $ * Single Credit Card Sale or Transaction Add Banking Information (Optional) Customer can do this on their own once they receive a link to tilled Merchant App Account Holder or Business Name Bank Name Account Number Transit Number Institution ID Captcha Submit If you are human, leave this field blank.
