Merchant Information Form

Expectations

You’re off to a great start! Now that you’ve booked your initial consultation, we’ll need some information from you to ensure a fast and simple conversion to your next merchant service provider.

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Your information is secured and only used to streamline the application process with the processor you choose. After the consultation with your agent, we’ll have 3 bids for you to choose from within 24 hours.

Additional Information Needed at Consultation

  • Signor's Social Security No.

  • Signor's Date of Birth

  • Driver License No.

  • Bank Account: Business Name

  • Bank Information: Account # and Routing #

  • Terminal/VAR/POS: (Make/Model)

*Top 3 – is based on competitive pricing, customer service reviews, product offering, and available promotions to the business.
**one-time fee is applicable per application occurrence. Additional merchant accounts (MID’s) will be assessed $25 per application. Multiple terminal locations (TID’s) are waived