Agent offices

Apply for a VitaPay office.

You already have agents. Tell us about the book and we will come back with terms: the split, how your agents are paid, and what each of them sees.

Office legal business name

City

State

Roughly how many agents do you have under you?Sub-agents included. An estimate is fine.

Who do you process through today?Tell us and we compare like for like instead of guessing.

Office application documents

Please provide all three documents below so we can review your office application.

Tax ID document

Upload the IRS document confirming your business tax ID, such as an EIN confirmation letter.

Photos or PDF, up to 10 files, 25 MB each, 60 MB total per submission. You can also drop them here or paste a screenshot.

Office representative’s driver’s license

Upload the driver’s license of the authorized representative applying for this office.

Photos or PDF, up to 10 files, 25 MB each, 60 MB total per submission. You can also drop them here or paste a screenshot.

Voided check

Upload a check marked VOID for the account that will receive your payouts.

Photos or PDF, up to 10 files, 25 MB each, 60 MB total per submission. You can also drop them here or paste a screenshot.

Office representative details

Authorized office representative’s full name

Office contact email

Office contact phoneStart with + for a number outside the US.

Agent or referral codeOptional. If an agent or an office sent you here, their code credits them for the introduction.

We use these details to review your application and contact you about next steps.

This form is protected by reCAPTCHA. Google’s Privacy Policy and Terms of Service apply.

Back

Submitting an application does not guarantee approval. We use your information and documents to review your application. Read our Privacy Policy and Terms of Use.