Feenix Legacy

Merchant Intake

Complete all sections and submit with the required processing statements.

Six (6) months of the merchant’s most recent processing statements are required with submission. You can also download the PDF intake form and email submissions to intake@feenixlegacy.com.

Download the PDF intake form

Agent Information

Agent nameAgent ID

Business Information

Business legal nameDBA nameTax ID (EIN)IndustryWebsiteCurrent POS / gateway used to accept credit cardsBusiness descriptionBusiness phoneBusiness start dateBusiness address

Owner Information

Owner first nameOwner last nameOwner titleOwner emailOwner mobile phoneDate of birth% ownershipSSNHome address

Banking & Processing

Bank nameRouting numberAccount numberAverage monthly card volumeAverage transaction amount% card present% card not present

Card-present and card-not-present must total 100%.

Authorization & SignatureBy signing below, the undersigned certifies that the information provided in this form is true, accurate, and complete, and authorizes FCA Funding 2026, LLC, Feenix Payment Systems, LLC, and their affiliates, agents, and designees to obtain consumer credit reports, business credit reports, and other credit and background information about the undersigned and the business, now and periodically as needed, in connection with the review, underwriting, funding, servicing, and collection of the merchant's application and any resulting program participation. The undersigned further authorizes the verification of any information provided, including banking and processing history.

Printed nameTitleDate

Submitted information is used solely for underwriting and program administration. Confidential.

Fields marked by your browser are required to submit. Six months of processing statements must be sent with the submission.