Pre Application – Offshore High Risk Merchants

Find Us

Call Toll Free:
1-877-724-6945 (United States and Canada)
International Call :
518.300.3786
Email :
[email protected]

Pre Application

** Type of Payment Method:
** Type of Account required:
Name of Business:
 *
Contact Name:
 *
Contact Email:
 *
Business Address:
 *
State/Province
:
 *
Zip/Postal Code:
 *
Daytime Phone:
 *
Business Fax:
 *
Legal Name of Business:
 *
Principal Owner:
 *
Type of Product or Service Sold:
 *
Age of Business:
 *
** What credit cards do you currently accept ?:
Who is your current processor:
 *
Indicate Monthly Visa and MasterCard volume:
 *
What is your average sales ticket:
 *
What is your website url:
 *
Which country are you incoporated in?:
 *
What percent is your monthly chargebacks?:
 *
** Direct or 3rd Party Account (new business):
Comments:
Type this :



-------------------