Clover Pre-Application

Let's get started

Who are we speaking with?

First name*

Last name*

Email*

What's the best email to reach you personally?

Phone*

What's the best number to reach you personally?

Title*

What's your position / role in the business?

About the business

Please fill in the details below

Company DBA (doing business as) name*

The nice sounding name people know you as.

Company legal name*

If your business is a Sole Proprietorship, the legal name is the owner's name.

Legal structure*Sole ProprietorshipPartnershipPrivate CorporationNon-Profit

Month/Year started*

When the legal entity was created / incorporated / registered.

Legal address*

The official registered address of the company. If it is a Sole Proprietorship, this is your home address.

Location address

The physical location you operate out of (restaurant, store, salon etc.), you may leave this blank if it is the same as the legal address.

Number of employees*

Business summary*

A brief explanation of the core service(s) and/or product(s) you offer.

Email*

Business email address for statements and official communications.

Cell Phone (optional)

A phone that can receive text messages that we may use to send time-sensitive important alerts only, such as outages.

Website (optional)

You may also put a profile page (Facebook, etc.) if you don't have your own site.

Accepting Payments

Choose your terminal(s), tell us a bit about your business' processing behaviour, and select your rate

Equipment*

Terminals you're interested in*Clover FlexClover Mini (solo)Clover Mini-to-MiniClover Station SoloClover Station DuoClover Online (Virtual Terminal only)

Clover Flex

Number of Clover Flex devices

Select Clover Flex payment optionRentBuy

Travel kit ($40 each)

Includes carrying case and charging cable.

Enter number of travel kits:

Clover Mini (solo)

Number of Clover Mini devices

Select Clover Mini payment optionRentLease to ownBuy

Clover Mini accessories

Select any you are interested in.

Swivel Stand ($50)Cash Drawer ($169)Handheld Barcode Scanner ($189)Hands Free Barcode Scanner ($275)

Clover Mini-to-Mini

Number of Clover Mini-to-Mini setups (2 devices)

Each setup requires a tethering cable ($20 purchase) and will be added for you.

Select Clover Mini-to-Mini payment optionRentLease to ownBuy

Clover Mini accessories

Select any you are interested in.

Cash Drawer ($169)Handheld Barcode Scanner ($189)Hands Free Barcode Scanner ($275)

Clover Station Duo

Number of Clover Station Duo setups

Includes 14" merchant-facing screen, 7" customer-facing screen (similar to a Clover Mini), and stand alone printer.

Select Clover Station Duo payment optionLease to ownBuy

Clover Station Duo accessories

Select any you are interested in.

Cash Drawer ($169)Handheld Barcode Scanner ($189)Hands Free Barcode Scanner ($275)

Where would you like your device(s) shipped?*Legal addressLocation addressOther

Behaviour*

What is your estimated total annual sales?*

A ballpark of all cash and card sales in a year (does not need to be exact).

What is the average transaction size?*

The typical order size from a customer (does not need to be exact).

What is the maximum transaction size?*

The largest purchase you would expect (does not need to be exact).

Do your customers pay in advance for products/services?*YesNo

If yes,

What percentage of the sale is paid in advance?

On average, how long from date of payment for delivery/fulfillment?

How late are you open until?*

Please include time zone designation.

Attachments

ID & banking documents

Principals*

Number of Principals required*

Principals must jointly represent at least 51% ownership in the business.

1 Principal2 Principals3 Principals

1st Principal*

Government-Issued Photo ID*

Driver's licence or passport (Image or PDF file).

Upload Photo ID

Max file size 10MB.

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ID Number*

The unique licence or passport number (e.g. in the top-right of passports).

First Name*

Last Name*

Home Address*

Date of Birth*

Official Title*

Ownership %*

Phone*

The best number to reach them personally.

Email*

The email you would like to use for e-signature.

Documents*

Bank document*

Void cheque for the account you'd like your deposits sent to.

No starter cheques allowed. Digitally-generated PDF void cheque from your online banking is OK. PAD (pre-authorized debit) and DDA (direct deposit authorization) forms are also OK, often available through your online banking.

Upload Bank Document

Max file size 10MB.

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Additional documents (optional)

Incorporation papers, business registration, business licenses (master licence, liquor, taxi, etc.), statement from current processor, photo of storefront & signage, photo of interior of business.

Whatever you'd like to provide could help expedite things as we may need to ask later.

Click to open upload area

Additional document 1

Max file size 10MB.

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Additional document 2

Max file size 10MB.

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Additional document 3

Max file size 10MB.

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Additional document 4

Max file size 10MB.

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Additional document 5

Max file size 10MB.

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Comments

(optional)

Also, anything else we should know?

Special circumstances we should be aware of?
Someone we should thank for referring you to us?
Feedback about this form?
We'd love to hear from you!

This is a pre-application. You will be sent the official application to review before you digitally sign.

For processing rate, see our pricing page to get your instant personalized rate.

We will reach out after you submit this form to confirm receipt, and to answer any and all questions you may have.

Thank you for choosing Discount Payments!