5 Minute Application Helios Payments (EU)

Business Information

Legal Name*

*If sole proprietor enter your first and last name only, otherwise legal company name here

Type of Ownership*

DBA*

*(Doing Business As) This will appear on cardholder’s statement as the charge

Legal Address*

Premises Type

Length at Location*

Business Phone*

*Please enter numbers only no spaces or dashes

Tax ID*

*Please enter numbers only no spaces or dashes

Email Address*

Type of Business*

*What type of product or service do you offer?

Length of Ownership

*Please enter numbers only no spaces or dashes

Website Link

Personal Information

Full Name*

Address*

Time At Current Residence*

Personal Identification Number*

*Please enter numbers only no spaces or dashes

Passport Number*

Date of Birth*

Personal Phone*

*Please enter numbers only no spaces or dashes

Personal Email*

Bank Information

Bank Name*

IBAN Number/Bank Account Number:*

*Please enter numbers only no spaces or dashes

SWIFT Code*

*Please enter numbers only no spaces or dashes

Documents

Certificate of Incorporation *

Articles/ Memorandum of Association*

Business License, if applicable

Principals Passport/ID*

Owner's Utility bill*

Bank Letter*

Domain Proof of Ownership*

3 Months Merchant Processing Statements

Credit Card Information

Currently Processing?*

Yes No

How Are You Taking Cards?*

In Person Swipe Online Over The Phone

Sales Currency(s)*

*Please enter numbers only no commas, or currency symbol

Max. Monthly Sales (in sales currency)*

*Please enter numbers only no commas, dollar sign or spaces

Average/Highest Tickets*

*Average Transaction Size

*Highest Average Transaction Size

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5 Minute Application (EU)