Business legal name *
Date of incorporation *
Jurisdiction of incorporation * Select an option Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Federal (Canada) Outside Canada
Industry * Select an option Agriculture Arts and entertainment Construction and trades Consulting and professional services Courier, delivery and logistics Education and training Financial services Food and hospitality Gig economy and on-demand platforms Healthcare and wellness Insurance Manufacturing Marketing and advertising Non-profit Real estate and property management Retail and e-commerce Sales and direct marketing Staffing and recruitment Technology and software Transportation Other
Legal address *
City *
Province or territory * Select an option Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Outside Canada
Postal code *
Country *
Mailing address (if different)
Describe your core business activities *
Primary use case * Select an option Incentive payments Commissions Gig and contractor payments Approved business disbursements Other permitted business use
Who will receive the cards? *
Estimated number of cardholders * Select an option 1 - 25 26 - 100 101 - 500 501 - 2,000 More than 2,000
Estimated monthly funding * Select an option Under $10,000 $10,000 - $50,000 $50,000 - $250,000 Over $250,000
Card format of interest Select an option Physical cards Virtual cards Both / not sure yet
Source of funds * Where the money loaded to cards comes from, for example business operating revenue.
First name *
Last name *
Position in company *
Email *
Phone *
Beneficial owner details * For each owner: full name, date of birth, ownership percentage, occupation and residential address.
Signatory full name *
Signatory position *
Signatory date of birth *
Signatory email *
Signatory residential address *
Additional notes
I confirm this information is accurate and complete, and I authorize SAL Processing Solutions and its authorized issuing and program partners to obtain and verify information about the business and its principals for business due diligence. *
