Important: The banks will only approve your application if you meet the following requirements. Please do not apply if you cannot meet the following requirements at this time.

A. You must be a US citizen, at least 18 years of age or have a US federal tax ID and not currently going through a bankruptcy. If you had a past bankruptcy and it is charged off we can still get you approved.

B.Your business must be located in the US and you must have a physical street address.


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Fill out our No Obligation Qualification Form - this is your first step to accepting credit cards.

By filling out this you will "not enter" in to any obligations or contracts with us. We will use it to determine the best program to offer you based on the information you provide.

You will be contacted by one of our representatives within 1 business days to go over the rest of your account set up. Our certified staff will teach you to walk, talk and learn the merchant processing industry lingo. Not only will you know you're merchant program, you'll get that "pampered" feeling with our helpful staff.

Note: All Information Provided To Us Will Remain 100% Confidential And Not Sold To Anyone !!

NO APPLICATION FEE!

Merchant Service Application - Business Information
Owner's Name: 
Contact Name:
If Different:
Legal Name of Business:
Doing Business as name (DBA): 
Business Street Address: 
(Not PO Box): 


City:  State: 
ZIP: Country: 
Business Phone Number:
FAX Number:
Date The Business Opened (Month/Day/Year): 
Product or Service Sold:
Percent Mail Order:
Percent Internet Orders:
Amount of Average Sales Ticket:
Estimated Monthly Sales Volume:
Your Daily Business Hours:
Your Email Address:
WWW Site Address 
(If Applicable):
Best Phone Number To Reach Applicant:
Do You Currently Accept Credit Cards ? Yes
No
Who is your current provider and what is the reason for you leaving?
How Did You Hear About Us?
* Note: This has to be filled in for the form to work.

Which particular  search engine brought you here and what search term did you use to find us?  Example: Infoseek - searching for merchant accounts. 
What Kind Of Equipment Do You Want To Process  Your Credit Card Orders ? Terminal
PC Software
Macintosh Software
Realtime Online Processing
Equipment?
I already own a terminal
I already own software 
How Soon Do You Want to Be Set Up?
Business Owners Information
Home Address:
 City:  State:  
 ZIP: 
  Country: 
Home Phone Number: 
Please Self Rate Your Credit. Excellent
Fair
Poor
Previous Bankruptcy.  Year?
Additional Comments or Questions:

 

 

Home Page | Services | Rates | Apply Online | eProcessingNetwork | Adult Links

 

Copyright 2002 Merchant Services USA. All rights reserved.