Stripe Authorization Form

Accept Website Credit Card Payments

Suite Edge, LLC. Secure Form for Activating Your Website

with Stripe to accept Credit Card payments to your bank.

Accept your website credit card payment into your designated bank account.
Please enter the bank information you wish to use for all credit card payments/purchases to be sent to:
This includes any purchases, services, memberships & reoccurring purchases from your customers

Payment Authorization Form - Stripe

BANK RECEIVING INFORMATION

Company Name

First Name

Last Name

Job Title

Date of Birth

Phone#

Billing Addresss

Billing Address

City

State

Zip

BANK INFO

Account Type

Checking

Savings

Routing#

Account#

Name On Account

Last 4 Social (Security Check)

TAX - LEGAL BUSINESS ENTITY

Legal Business Name

Tax ID#

MONTHLY SERVICES

I Agree to have Suite Edge, LLC Configure My Website to accept credit card payments via Stripe

Date

By submitting this form, you agree you certify that the information provided is complete and correct.
Stripe, Inc. is a registered ISO of Wells Fargo Bank, N.A., Concord, CA.