Business Name

Legal Business Name

What is your Business Type/Industry?

How long have you been in business?

Business Website

Owner's Name

Owner's Phone number

Owner's Email

What 1791 Financial Services Associate are you working with?

Do you currently accept credit card payments? If so, what system do you use?

What is your approximate monthly processing volume?

Which of these payment processing challenges impact your business the most?

High or unpredictable transaction fees

Delayed access to funds (slow settlement times)

Unexpected system outages or payment failures

Complicated onboarding and application processes

Security and data protection concerns

Integration issues with other business systems

Customer dissatisfaction during checkout

Inadequate technical support or service

Difficulty comparing providers and understanding options

Do you clearly understand all the fees you’re currently paying?

Yes, completely transparent and understandable

Somewhat clear, but some fees are confusing

No, my statement is confusing and difficult to interpret

Not applicable (not currently processing)

Have you reviewed your insurance policies in the last 12 months?

Who does your bookkeeping and taxes? And which bookkeeping software do you use?

Does your bookkeeper provide ongoing insights on how to stop profit leaks?

Yes

We strongly believe that more of your hard-earned profits should stay in your pocket. We don't just provide you with financial solutions for your business, we take a comprehensive financial planning approach to ensure you and your loved ones are truly benefiting from your business. How often are you meeting with your current Financial Advisor?

Are you looking to implement The 1791 Profit System?

How would you like to partner with us? Is there anything you want us to focus on first?

The information you provide in this form will be used solely to understand your business needs and prepare for our consultation. We maintain strict confidentiality of all client information and implement appropriate security measures to protect your data. We do not sell or share your information with third parties except as required to provide our services. By submitting this form, you consent to our collection and use of your information for these purposes. You may request access to, correction of, or deletion of your information at any time by contacting us.ee to receive text messages from the business.