LendingUSA Applications

Merchant Enrollment Application

Please tell us more about your business to get started

Business Information

Legal Business NameRequired

D.B.A.Optional

Business Category Type

Street AddressRequired

✓Verify Address

CityRequired

State

Zip Required

Federal Tax ID#Required

Years Under Current OwnershipRequired

Ownership Type

Bank name

Account Holder Name

Bank Account Number

Bank Routing Number

Principal Owner Information

First NameRequired

Last NameRequired

Social Security NumberOptional

Date of BirthRequired

Email AddressRequired

Phone NumberRequired

Street AddressRequired

✓Verify Address

CityRequired

State

Zip Required

Primary Financing Contact

Add the person who oversees financing at this location and will receive email to set up merchant portal login credentials.

Same as Owner

First NameRequired

Last NameRequired

Job TitleRequired

Email AddressRequired

Main Office Phone #Required

Your Signature

Electronic Signature Agreement. By selecting the "Submit Application" button, you are signing this Merchant Enrollment Application ("Application") electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Application. By selecting "Submit Application" you consent to be legally bound by LendingUSA, LLC's ("LendingUSA") terms and conditions. You further agree that your use of a key pad, mouse or other device to select an item, button, icon or similar act/action on lendingusa.com or any of its affiliated websites constitutes your signature (hereafter referred to as "E-Signature"). You also agree that no third-party verification is necessary to validate your E-Signature, and that the lack of such third-party verification will not in any way affect the enforceability of your E-Signature, or of any resulting agreement between you and LendingUSA. You also certify to LendingUSA that you are the duly authorized representative of the business and are authorized to provide the information and submit the Application on behalf of the business. You further understand and acknowledge that your submission of the Application will bind the owner and/or business to LendingUSA's policies and terms and conditions as contained on LendingUSA.com's website and as disclosed to you in this Application as of the date of your E-Signature.

Principal Owner E-SignatureRequired

Job TitleRequired

Date

By submitting this application, you agree not to disclose the Merchant Discount Fee (MDF), or any difference between the Payout Amount and the Financed Price to your Customers, and further agree not to impose the MDF on any Customer either by charging the Customer directly for the MDF or indirectly by charging a higher cost for your goods or services.

Merchant Enrollment Application

Business Information

Principal Owner Information

Primary Financing Contact

Need Help?

Testimonials

Your Signature