New Merchant Intake Form

Principle Information

General Business Information

MerchandisingManufacturingFood ServiceHealthHotel/EntertainmentFinancialOther

Applicable Services (check all that apply)

Services Needed:

Visa/Mastercard/DiscoverAMEXWeb Integration

Are you currently Processing Credit Cards?

Yes (with who?) 

How You Process (%)

Special Requirement/Notes:

Action To Take:

Please submit 1 month's statement, PER LOCATION, to for comparison and proposal of savings.

Why We Need Statment:

  • Only way to accurately compare rate savings. Each card has a different cost or interchange rate (think AMEX vs Debit card). We supplement our rates on same CC cards used so customer can evaluate a true savings figure.

  • Create custom pricing model that is specific for business type and historical card usage categories.

  • Expedite underwriting process and preapprove credit limitations; especially crucial for high volume, high ticket, or high risk accounts.