Merchant Application

Legal Business Name

DBA

Address

Does your business have a separate legal/mailing address?

EIN (Tax ID)

Established Year

Phone

Contact Name

First

Last

Website URL

Agent Name

Business Description

Average Ticket

High Ticket

What is the total amount you process a month in credit cards?

Is your business seasonal?

Do you have a refund policy?

What is the percentage of each credit card transaction type: Card Present / Card Not Present / Internet?

Example: Card Present 50% / Card Not Present 25% / Internet 25%

File Upload

Click or drag files to this area to upload. You can upload up to 4 files.

Please upload the following documents, if available. 1. Certificate of Incorporation 2. Driver License