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Credit Card Processing Application
Once you complete this application, we will be able to get your account going and get your new equipment out to you, so you can begin saving money!
Legal Name of Business:
*
Legal Address:
*
Phone:
*
Email:
*
Fed Tax ID:
*
In Business For (Years/Months):
*
Type of Corporation:
*
Web Address:
*
Owner Name:
*
Owner Email:
*
DOB:
*
SSN:
*
DL #:
*
Owner Address:
*
Owner Phone:
*
Card Swipe Trans %:
*
Average Ticket Amount:
*
Total Monthly CC Sales $:
*
High Ticket Amount $:
*
Number of Locations:
*
Bank Account Type:
*
Routing #:
*
Account #:
*
Terminal/POS Needed:
Number of Terminals Needed:
*
Detailed Explanation of Merchandise/Products/Services Sold:
*
Voided Check
*
Upload File
Previous Processing Statement if Currently Processing
Upload File
Drivers License
*
Upload File
Signature
*
Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.
Submit
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