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Online Credit Card Transactions for $39.95!!
Lease to own your merchant account equipment, software, and shopping cart system for only $39.95 per month! WE GUARANTEE APPROVAL no matter what your credit status may be!
The benefits include:
* 2% Discount Rate
* No Monthly Minimum Billing Fee
* No Statement Fee if No Sales Made for the Month
* Money Available in 3 Business Days
* Windows-Based or Macintosh Compatible Credit Card Processing Software (Available)
* Shopping Cart System To Take Orders Securely Right On-Line (Available)
* Checks By Fax/Email/Phone software.
Please call us at 912-236-6676 for more information.
Please fill out the form below and fax to 970-927-0964.
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Merchant Account Application
Legal Business Name: ____
State: __________________
DBA: ____________________
Business Address: _______
Suite: __________________
City State Zip: _________
Describe Business: ______
Business Hours: _________
Percent Mail Order: _____
Percent Phone Orders: ___
Percent Trade Show: _____
Locations: ______________
Year Started: ___________
Fed Tax ID: _____________
State Tax ID: ___________
Principal Contact: ______
Title: __________________
Phone No: _______________
Fax No: _________________
Est Card Sales Month: ___
Average Ticket: _________
Type of Business: _______
State Incorporated: _____
Age of Business: ________
Date Acquired: __________
OWNER PRINCIPAL INFORMATION:
President Owner: ________
Title: __________________
Ownership: ______________
Residence Address: ______
City State Zip: _________
Own Rent: _______________
Since: __________________
Home Phone: _____________
Previous Address: _______
DOB: ____________________
CO OWNER INFORMATION:
Co-Owner: _______________
Title: __________________
Percent Owned: __________
Residence Address: ______
City State Zip: _________
Since: __________________
Own Rent: _______________
BUSINESS TYPE:
Type of Building: _______
Found EMS By: ___________
CREDIT INFO:
Rank Your Credit: _______
Prior Bankrupt: _________
Year: ___________________
TERMINAL:
Prefer PC Software or Terminal?: ___
Terms/Lease or Purchase?: __________________
REFERENCES:
BUSINESS REFERENCES: (Please list three)