BeDauntless

Information needed from merchant for Dauntless Pay.
Exempt Payee
501(c)Excempt

Beneficial Owner / Signer Information

Authorized Signer (If not Beneficial Owner)

Banking Information

Card Processing Information

Card Types Requested:

Credit Card Processing Methods (if Applicable) – Row Total Must Equal 100%

Customer Transaction Type – Row Total Must Equal 100%

SITE SURVEY: FULFILLMENT / MARKETING

Refund Policy:
If yes, Indicate Months Active:

TRADE REFERENCES