Signer Information

US Commerce LLC — Payment Processor Application

This form collects sensitive personal information required by our payment processor to verify your identity as a US signer for our merchant account application. Submission is encrypted in transit and at rest. Information is shared only with the payment processor.

Personal Information

First Name *

Last Name *

Email *

Phone *

Date of Birth *

Social Security Number *

Encrypted before storage. Format: 9 digits, dashes optional.

Home Address

Street Address *

Apartment / Suite / Unit

City *

State *

ZIP *

Driver's License

Driver's License — Front *

JPG, PNG, or HEIC. Max 8 MB.

Driver's License — Back *

JPG, PNG, or HEIC. Max 8 MB.

By submitting, you confirm the information is accurate and authorize US Commerce LLC to share it with our payment processor.