Merchant Application

Promo Code

Business Information

Business Type
State of Formation

Also referred to as TIN

This number will appear on your customers’ statements.

License State

Processing Information

Industry Other

You should use your current processing statements as a guide. If you do not have a current processor, use your current projected annual sales.

Refund Policy
Please specify refund policy

MCC must be 4-digit number.

Business Banking Information

Account Type

Your Information

Provide information for person completing the application

State of Issuance
State of Issuance