Paystand Beneficial Owners

Paystand Underwriting: Beneficial Owners

It is required that payment processors collect information on the beneficial owners of your firm. A beneficial owner is anyone legally owning 25% (or more) of your firm, such as possessing 25% or more of the company shares.
Legal Name of Firm
This should be the exact same name as you entered in the underwriting form you provided Paystand earlier.
Tax ID of Firm
This is the tax id (eg, EIN, FEIN) of your company. Again, it should match the tax id you provided in your Paystand merchant application.
How many beneficial owners does your company have?
Business Representative: Full Name

First NameLast Name
Business Representative: Email Address
Business Representative: Residential Address

Residential Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Business Representative: Are they a US citizen?
Business Representative: Social Security Number
Business Representative: Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Business Representative: Passport Number / Visa ID
Beneficial Owner #1 : Full Name

First NameLast Name
Beneficial Owner #1: Email Address
Beneficial Owner #1 : Residential Address

Residential Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Beneficial Owner #1: Are they a US citizen?
Beneficial Owner #1 : Social Security Number
Only required if beneficial owner #1 is a citizen of the United States of America
Beneficial Owner #1 : Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Beneficial Owner #1 : Passport Number / Visa ID
Only required if beneficial owner #1 is not a citizen of the United States of America
Beneficial Owner #2 : Full Name

First NameLast Name
Beneficial Owner #2: Email Address
Beneficial Owner #2 : Residential Address

Residential Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Beneficial Owner #2: Are they a US citizen?
Beneficial Owner #2 : Social Security Number
Only required if beneficial owner #2 is a citizen of the United States of America
Beneficial Owner #2 : Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Beneficial Owner #2 : Passport Number / Visa ID
Only required if beneficial owner #2 is not a citizen of the United States of America
Beneficial Owner #3 : Full Name

First NameLast Name
Beneficial Owner #3: Email Address
Beneficial Owner #3 : Residential Address

Residential Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Beneficial Owner #3: Are they a US citizen?
Beneficial Owner #3 : Social Security Number
Only required if beneficial owner #3 is a citizen of the United States of America
Beneficial Owner #3 : Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Beneficial Owner #3 : Passport Number / Visa ID
Only required if beneficial owner #3 is not a citizen of the United States of America
Beneficial Owner #4 : Full Name

First NameLast Name
Beneficial Owner #4: Email Address
Beneficial Owner #4 : Residential Address

Residential Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Beneficial Owner #4: Are they a US citizen?
Beneficial Owner #4 : Social Security Number
Only required if beneficial owner #4 is a citizen of the United States of America
Beneficial Owner #4 : Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Beneficial Owner #4 : Passport / Visa ID
Only required if beneficial owner #4 is not a citizen of the United States of America
Do the beneficial owners / business representative on this form also apply to other legal entities (subsidiaries or affiliates) that use Paystand? Note: If this information does not apply to all of your legal entities, a separate form must be completed for each legal entity.
Which legal entity does this information apply to? If it applies to more than one, please list each of them.
Notice

Merchant warrants that the information provided on this Paystand (and subsidiaries) Merchant Processing Application (“Application”) is complete and accurate. Merchant, and its signing representative, authorize Paystand (and subsidiaries) to make, from any time, any business credit and other inquiries, including to its merchant account and/or Internet merchant account provider(s). Merchant shall be notified regarding approval of its Application and any limits or other requirements regarding the payment processing service. Capitalized terms not defined in the Application are defined in the Paystand (and subsidiaries) Terms and Conditions. Upon approval of its Application, Merchant agrees to comply with the Terms and Conditions of Paystand (and subsidiaries).
IN WITNESS WHEREOF, Merchant has caused this Application to be executed by its duty-authorized representative on the date below.
Full Name of Signatory
Signatory's Company Email
Signature
Should be Empty:

Paystand Underwriting: Beneficial Owners

Notice