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REQUIRED if you take EBT




Help us understand your business! We'll use these values for fraud prevention and risk mitigation, so please be as accurate as you can.
$
If your monthly volume fluctuates, input your largest month
$
AMEX sales will fund with Visa/MasterCard sales at great low rates
$
Calculate by dividing your monthly volume by the number of sales
$
To help us protect you from fraud, what's the biggest sale you'll take?


Listed on your tax returns
Please do NOT include dashes.




















You'll answer "0" if you sell in-person






This account will be for your deposits and fee withdrawals. You'll get paid for your gross deposits throughout the month, and then our fees will be automatically debited from the below bank account on a monthly basis.


This is always 9 digits long.



All of the below requested information is required. Each signer's Social Security Number will be required when you electronically sign the DocuSign application we email to you. 











This is required for identity verification.

%
What % of the business does the signer own? 

2nd Signer/Owner

All of the below requested information is required. Each signer/owner's Social Security Number will be required when you electronically sign the DocuSign application we email to you. 





Please use a DIFFERENT email address than the first signer - we require a unique email.






This is required for identity verification.

%
What % of the business does the signer own? 

3rd Owner

All of the below requested information is required. Each owner's Social Security Number will be required when you electronically sign the DocuSign application we email to you. 





Please use a DIFFERENT email address than the first signer - we require a unique email.






This is required for identity verification.

%
What % of the business does the signer own? 

4th Owner

All of the below requested information is required. Each owner's Social Security Number will be required when you electronically sign the DocuSign application we email to you. 





Please use a DIFFERENT email address than the first signer - we require a unique email.






This is required for identity verification.

%
What % of the business does the signer own? 

Help us understand who your customers are. Please fill in the below boxes with your best estimations for who you accept credit cards from:

%
%
%
%


Let us know what percentage of your sales are swiped, keyed, or online.

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%
%
Please note! If you're processing internet sales AND card-present retail sales, we may require a separate account for your eCommerce transactions, per Visa/MC guidelines. Your salesperson will assist with this step if necessary.
%


If you automatically bill your clients at specific intervals, please adjust the below. If you only charge your customers once and don't save their payment information, you can skip this. 
 
%
%
%
%


 

MX Merchant

All Dharma accounts come with free access to MX Merchant. This includes a Virtual Terminal, Customer Database,, and Phone app. 



Clover Go

Clover go carries an additional $10/month fee, per account. Clover Go works with both Apple and Android devices. Please note! Clover Go devices do not carry a warranty. They'll be replaced if they arrive defective, but future issues will not be covered by Clover.
Clover Go

Go Contactless

Gateway Options


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$



Please tell us anything important about your new setup. What shopping cart will you use? Do you have any specific needs for your gateway? Let us know how we can best assist!


Clover Options



clover station duo(s)
Clover Mini

clover mini(s)
Clover Flex

clover flex units




Clover Mini device(s) at $1049 each                                                                                                          

Clover Flex device(s) at $799 each                                                                                                       

Kitchen Printer(s) at $399 each                                                                                                       

Weight Scale(s) at $399 each                                                                                                                    

Barcode Scanner(s) at $159 each                                                                                                   

Label Maker at $399 each                                                                                                   

Cash Drawer(s) at $99 each                                                                                                       

Swivel Stand(s) at $99 each                                                                                                        

$
All Clover Setup Fees will be withdrawn from account on file upon approval.
Please Review your Clover Setup Fees for accuracy. 
 
Clover Station Duo Costs
Station Pro includes 14" Touchscreen, Clover Mini, and High-Speed Printer

Quantity:    
x    $2199 = 

$
Clover Mini Costs

Quantity:    
x    $1049 = 

$
Clover Flex Costs

Quantity:    
x    $799 = 

$
Clover Accessory Costs

Kitchen Printer Quantity:       
 x    $399 = 

$

Weight Scale Quantity:        
 x    $399 = 

$

Barcode Scanner Quantity:  
 x    $159 = 

$

Cash Drawer Quantity:   
 x      $99 = 

$

Swivel Stand Quantity:    
 x      $99 = 

$

Label Maker Quantity:     
 x    $399 = 

$
   

Terminal Selection




$
FD-130 Terminal
FD-130 Terminal + PinPad Combo
Desk 3500
Desk 3500-1500
V200c Terminal
V200c Terminal + P200
Dejavoo Z11 Terminal
Devajoo Z11 + Z6 PinPad




You must settle prior to 9pm Eastern time in order to receive the fastest possible funding.

You must settle prior to 7pm Eastern time in order to receive the fastest possible funding.

Business Documentation

The following documents must be submitted for final application approval. Please securely submit all documentation below. If you're unable to electronically submit your documentation, you may fax documents to (415) 632-1921, or email directly to your sales representative. 


You can upload a 501c3 document, business license, articles of incorporation, or tax document.

We'll need proof of your bank account. That proof can either be a pre-printed, voided check, OR a signed bank letter on bank letterhead detailing the account name, ABA routing number, and account number.

Please upload your past three months' processing statements from your current provider. Click the "Upload Another" button on the right to upload multiple files.

Please upload any other documentation that may be relevant to a new merchant account. This could include marketing materials, purchasing contracts, customer agreements, business financial documents, pricing lists, or any other documentation that may not be available on your website, yet is important for us to know!
To provide you with the best possible service, If Dharma determines we are unable to support you directly, we will share your information with a Dharma partner that may be able to support you.


4aGoodCause

Ready to move forward with 4aGoodCause and Dharma?

Great! Fill out the form to the right to get the process started.