New Merchant Inquiry

This field is for validation purposes and should be left unchanged.

Business Info

We can only work with Merchants Incorporated in US, Canada, Mexico, Australia, New Zealand, Switzerland, and the European Union.

Does any owner/principal have a valid U.S. SSN?*

Yes

A valid U.S. SSN is required for this submission.

Country of Incorporation or Registration*

We are unable to work with Merchants incorporated in India

Citizenship of Owner*

Industry of Business*

What Industry?*

Customer Breakdown by Country*

Please provide an estimated breakdown of which countries you sell in and the % of sales to each country (ex: 40% EU, 40% US, 20% Rest of World)

Country of Settlement Bank Account*

Legal Business Name*

DBA Name*

Do you have a business license?*

Yes

In what countries is your business licensed?*

Are you able to provide 1 to 3 months of processing statements?*

Merchants who provide processing history are more likely to get approved for a merchant account.

Yes

Have you ever had a Merchant Account Terminated?*

Yes

For what reason was your account terminated?*

Processing Requirements

Website*

Do customers have the ability to create an account on your website?*

This is typically used to log in and see orders, account info, etc.

Yes

Please create a test user account for Underwriters to use. They will need to see the section of your website that is restricted for customers

Test Username

Test Password

Operating Group (optional)

Do you automatically rebill your customers?*

Yes

Currency of Settlement Funds*

Average Transaction Amount ($)*

Please enter a number from 0 to 100000000.

Estimated Monthly Credit Card Sales Volume ($)*

Please enter a number from 0 to 100000000.

Maximum Transaction Amount ($)*

Please enter a number from 0 to 100000000.

Details

Detailed description of product or service you sell:*

Anything else you'd like us to know about your business:

Contact Info

Name*

First Last

Email*

Mobile Phone*

Upload Processing Statements

3 Months Previous Credit Card or ACH Processing Statements (if available)

Must be downloaded or scanned copies of the full monthly statement, not merely screenshots. These are available through your previous/current merchant account provider’s online login, or by calling your old credit card processor. For new businesses, or if you haven’t accepted credit cards in the past, omit this requirement. If, however, your bank statements indicate you’ve accepted credit cards in the past, you cannot be approved without providing those documents.