Holistic Payments and Financing — CBD & Cannabis Merchant Intake

Section 1 of 6

Business Background

Tell us about your company and its history.

Company / Brand Name *

What type of business are you? *

CBD only (≤0.3% THC)

Hemp-derived THC

Licensed dispensary

Multiple lines

How long have you been in business? *

Entity type

What state is your business registered in? *

What states do you sell into / ship to?

Website URL

Do you have any other businesses outside of CBD/cannabis?

Yes

No

If yes, describe and share processing history (include dispute rate if known)

Section 2 of 6

Product Details

What you sell determines which processors and card network rules apply.

What product categories do you sell? * (select all that apply)

Do any of your products contain Delta-8, Delta-9 THC, THC-A, HHC, or other intoxicating cannabinoids? *

Yes

No — CBD only

If yes, list the specific cannabinoids and products

What is the THC content of your products? *

THC-free / isolate

≤0.3% (Farm Bill)

Above 0.3% (licensed)

Mixed

Do you sell white-label or private-label products for other brands?

Yes

No

Do you make any health or medical claims on your website, packaging, or marketing? (pain relief, anxiety, sleep, anti-inflammatory, etc.)

Yes

No — compliant language

Section 3 of 6

Compliance & Licensing

Compliance is the biggest factor in getting approved. Be thorough here.

Do you hold a state hemp / CBD license? *

Yes

Not required

In progress

If you're a dispensary, do you hold a state cannabis license?

Yes

No

N/A — hemp only

Do you third-party lab test every batch? *

Yes — every batch

Some batches

No

What does your lab testing cover? (select all that apply)

Are your COAs (Certificates of Analysis) available to customers?

On website / QR code

On request

No

Do you follow cGMP (Current Good Manufacturing Practices)?

Yes

No

Third-party cGMP facility

Do you enforce age verification? (required for THC products in most states)

At checkout

At delivery

Both

Not required

Where are you sourcing your hemp / cannabis? *

Own farms

U.S. hemp farms

U.S. distributor

Imported

If imported, from where?

Do you carry product liability insurance?

Yes

No

Do you restrict shipments to states where your products are banned or in a legal gray area?

Yes — we block restricted states

No restrictions

Section 4 of 6

Sales Model & Distribution

How you sell and where your customers come from.

What are your sales channels? * (select all that apply)

Own website (DTC)

Own storefront

Wholesale

Marketplace

Where is most of your online traffic coming from?

What does your checkout flow look like?

Single purchase

Subscription / auto-ship

Both

What platform is your store on?

Section 5 of 6

Transaction & Risk Profile

Volume, chargebacks, and processing history.

Current or projected monthly revenue *

Average order value

Current chargeback / dispute rate (if you have processing history)

Do you have an existing merchant account or processor?

Yes

No

If yes, who and why are you looking to switch?

Have you ever been terminated by a processor, placed on MATCH/TMF, or had an account shut down?

Yes

No

If yes, explain what happened

What's your refund policy?

Average fulfillment / shipping time

What percentage of sales are online vs. in-store?

Section 6 of 6

Processing Needs

What you're looking for from us.

What payment methods do you need? * (select all that apply)

Credit / debit cards

ACH / eCheck

Crypto

In-store POS

Are you open to a rolling reserve? (common for CBD/cannabis merchants)

Yes

Depends on terms

No

Do you need a payment gateway recommendation or do you already have one?

Already have one

Need a recommendation

Anything else we should know?

No personal or financial information is collected in this form.