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Thank you for choosing Diversified Payments.

Please complete our simple sign up form below.

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Business Information

Merchant Legal Business Name
Merchant DBA Name
example@example.com
Please enter a valid phone number.
Federal Tax ID (Must be 9 digits)

Principle Information

(Must be 9 Digits)
example@example.com
Please type percentage of ownership ex. 23
Please type number of years in business ex. 23

Bank Information

Name of bank for merchant deposit
ex. 23
ex. 23

Processing Information

ex. 23
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.