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.