Purpose-Powered Payments — Onboarding Form

Purpose-Powered Payments

Onboarding Form

* Required fields must be completed before submission

1Business Info

2Ownership

3Authorized Signer

4Next Steps

Business Information

Legal business name *

DBA name (if applicable)

Federal tax ID / EIN

Website URL

Business email *

Fax number

Main phone *

Customer service phone

Physical address (no PO box) *

Legal address (if different)

Number of locations

Established date

Business ownership type *

Business location type

Previously accepted cards? *

Yes No

Previous processor (if yes)

Principal / Ownership Information

Provide the following information for each individual who owns, directly or indirectly, 25% or more of the equity interest of the business. If no single owner owns more than 25%, an individual with significant responsibility (e.g., CEO, CFO, Managing Member, General Partner, President, Vice President, or Treasurer) must be listed as Principal 1.

Principal 1 · Required

Full name *

Title *

Ownership %

Date of birth *

Phone *

Email *

Residential address *

Principal 2 If applicable

Full name

Title

Ownership %

Date of birth

Phone

Residential address

Principal 3 If applicable

Full name

Title

Ownership %

Date of birth

Phone

Residential address

Principal 4 If applicable

Full name

Title

Ownership %

Date of birth

Phone

Residential address

Authorized Signer Optional

Complete this section ONLY if an additional authorized signer is not already listed as a Principal above.

Full Name (First and Last)

Title / Position

Home / Mobile Phone

Date of Birth

Email Address

Home Address

City

State

Zip

Country

What Happens After You Submit

SSN Collection

A PIE team member will contact the principal owner(s) directly to collect their Social Security Number via a secure channel.

Secure Document Upload

We will send you a secure Dropbox link to upload the following required documents:

Copy of voided check or official bank letter
Driver's license, front and back, of all owners

Business Information

Principal / Ownership Information

Authorized Signer Optional

What Happens After You Submit

Purpose In Expenses LLC