Welcome!

We are excited to start working with you! In order to begin the boarding process, we need some information to get your application prepared. After completing this form, within just a few hours you will see an E-Mail from Leading Edge Payments to complete your application process. If you have any questions please call us at 888-675-6352, or contact us by email at [email protected].

Business Name (DBA)^*

Legal Name (Name on Tax Return)^*

Business Contact Name^*

Email^*

Business Address (Physical Address)^*

Studio Phone Number^*

Mailing Address^*

Same as Bussiness Address

Different than Business Address

Business Startup Date^*

State of Incorporation^*

Federal Tax ID/EIN# (Same as on tax return)^*

Business Structure^*

Processing Information

Is your studio currently accepting Credit Cards?^*

Yes

Ownership Information

Name^*

Date of Birth^*

Social Security Number (SSN)^* No dashes

Home Address^*

Owner Phone^*

Email^*

Ownership %^*

Please Upload a Picture/Scan of your Drivers License

Choose File No File Choosen

Are their Additional Owners with 25% or more Ownership?^*

Yes

Additional Owner 1

Name^*

Date of Birth^*

Social Security Number (SSN)^* No dashes

Home Address^*

Owner Phone^*

Email^*

Ownership %^*

Please Upload a Picture/Scan of your Drivers License

Choose File No File Choosen

Additional Owner 2

Name^*

Date of Birth^*

Social Security Number (SSN)^* No dashes

Home Address^*

Owner Phone^*

Email^*

Ownership %^*

Please Upload a Picture/Scan of your Drivers License

Choose File No File Choosen

Additional Owner 3

Name^*

Date of Birth^*

Social Security Number (SSN)^* No dashes

Home Address^*

Owner Phone^*

Email^*

Ownership %^*

Please Upload a Picture/Scan of your Drivers License

Choose File No File Choosen

Additional Owner 4

Name^*

Date of Birth^*

Social Security Number (SSN)^* No dashes

Home Address^*

Owner Phone^*

Email^*

Ownership %^*

Please Upload a Picture/Scan of your Drivers License

Choose File No File Choosen

Bank Account Information

Name of Banking Institution^*

Name on Check^*

Routing Number^*

Account Number^*

Upload a Voided Check for Your Deposits^*

Choose File No File Choosen