General Information

Full Name

Email *

Phone *

Business Name

Business Information

Do you currently utilize any specialized software applications or third-party integrations in your business operations?

Are you currently using a credit card processing terminal or point-of-sale system? If so, could you please specify the brand or provider name?

Have you previously switched credit card processing providers or payment systems?

What is your approximate monthly credit card transaction volume?

Document Upload

What is your average transaction amount per sale?

Are you aware of your current effective processing rate?

Referred By *

Incase none add "NA"

File Upload

Please upload your 2 recent merchant statement

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