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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.

%
%
%
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


$




$



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 Flex Pocket

clover flex pocket units

Clover Compact

clover compact units




Clover Mini device(s) at $899 each                                                                                                          

Clover Flex device(s) at $699 each                                                                                                       

Clover Flex Pocket device(s) at $649 each                                                                                                       

Kitchen Display System(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    $1999 = 

$
Clover Mini Costs

Quantity:    
x    $899 = 

$
Clover Flex Costs

Quantity:    
x    $699 = 

$
Clover Flex Pocket Costs

Quantity:    
x    $649 = 

$
Clover Compact Costs

Quantity:    
x    $299 = 

$
Clover Accessory Costs

KDS Quantity.                       
 x    $799 = 

$

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
Please Note: This terminal is only for use with MX Advantage for Surcharging, and should not be selected as a standard terminal
Devajoo Z11 + Z6 PinPad
Please Note: This terminal is only for use with MX Advantage for Surcharging, and should not be selected as a standard terminal. If you select this terminal, you are also agreeing to the $25 / month fee for MX Advantage




Please Note: This terminal is only for use with MX Advantage for Surcharging, and should not be selected as a standard terminal

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 current Driver's Licenses for each signer. Click the "Upload Another" button on the right to upload multiple files.

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

If you are a tex exempt nonprofit, in order to ensure you are not charged tax on any equipment purchase, please upload your Tax Exempt Certificate.

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!

By clicking “Submit” you agree to share your personal and business data with Dharma Payments LLC, for our use in determining if we can support you with a merchant processing account. Submission does not guarantee you will be approved for an account. If Dharma is unable to support you with a merchant processing account, we may, at our discretion, share basic contact information with a partner who may be able to support you. If we do, you will be informed, and that partner will contact you directly. If you do not agree with these terms, please close the window without clicking Submit and your data will not be captured or saved

Your data will never be sold or brokered to any third party. You can review our Privacy Policy here .


4aGoodCause

Ready to move forward with 4aGoodCause and Dharma?

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