Merchant Account Apply Now

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1 About You

2 Your Company

3 Your Website

4 Processing Insight

1 About You (the applicant)

The applicant is the first point of contact for this application.

First Name

Last Name

Address Line 1

Address Line 2

City

State

Zip Code / Post Code

Country

Telephone NumberYour Landline Number

Cell / Mobile NumberYour Cell / Mobile Phone Number

Emaila valid email

2 About your Company

This is the legal entity that's applying for a Merchant Account.

Company NameRegistered Name

Company NumberCompany's Registration Number

Date of Incorporation

Address Line 1

Addess Line 2

City

State

Zip Code / Post Code

Country

3 About your Website

We're collecting information about your website

Website URLThe Website on which you'll be taking payment

UsernameUsername for Website login

Password

Brief OverviewPlease give more details about your business

0 /

DescriptorThe wording that should appear on the customer's card statement

Do you offer Customer Support?Select all that apply

Noneby emailby phone

Are Contact Details stated on the websiteSelect all that apply

emailphonecontact form

What is the Fulfillment Time

Compliance

	Yes	No	Not Sure
Is the company identifiable at anytime by the card holder?
Is the address of the company presented on the website?
Do all products on the website comply to the same MCC code?
Are VISA/ Mastercard logos displayed on the website?
Is the transaction currency stated on the website?
Are prices displayed on the website?
Are Shipping Costs clearly stated on the website?
Is fulfillment time stated on website?
Is a Customer Services telephone number or email address available for the customer?
Is the return of goods procedure and policy stated on website?

4 Processing Information

Information about any processing history and expected processing with the new account

Processing History

	Yes	No
Do you currently accept credit cards?
Have you ever processed before?

If Yes, please specify reason for termination

0 /

Current or Former ProcessorName of Payment Processing Company

Time with current processorPlease specify number of months and years

Reason for leaving / applying for a new account

Other Currency

Estimated Monthly monetary value of the transactions

Estimated Number of sales per month

Average transaction amount

Minimum to Maximum ticket amount

Specify any other Payment methods used on the website

Are goods/services based on order forms signed by customer?

YesNo

By clicking the [Submit Form] button below, you agree that you have read and agree to our Terms & Conditions and Privacy Policy.

Applying for an account

On this form, we collect some basic information about the you, (the applicant), the business and your business’s website for assessment purposes only. If you have the information, you will typically need about 5 minutes to complete the form.

Section 1: Information about You
We collect basic contact information about the applicant.

Section 2: About your Company
We collect information about the legal entity which is applying for the merchant account.

You will need the Incorporation registration date and number.

Section 3: About your website
We collect information about the website that you will be taking payment on.

Section 4: Processing Information
This section collects information about the payments you want to take, sales volume and your existing or past processor.

What happens next…
We may ask for more information about the business and if the assessment is successful, we will request supporting documentation.

	Yes	No
Do you obtain a Proof of Delivery?
Do you use Delivery Companies for fulfillment?
Do they offer delivery tracking?