Credit Card Processing & Merchant Accounts

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Apply Now: Credit Card Processing Account

Company Information
Owner's Name:  Mr.  Ms.  Dr.
First:     Middle Initial:     Last:
Type of Ownership:
Ownership Percentage: %
Is This a Home-Based Business?
Date of Birth (MM/DD/YY): / /
Contact Name, If Different:
Legal Name of Business:
Doing Business as (DBA), If Applicable:
Company Address
Location of Business (No P.O. Boxes. If Home-Based, Enter Home Address):
Suite or Apartment # If Applicable
City: State:
ZIP:
Country: United States     Other
If home address is the same as business address, click this box:
Home Address:
Suite or Apartment # If Applicable
City:
State:
ZIP:
Country:
Home Phone Number: ( ) -
Business Phone Number: ( ) -
Best Phone Number To Reach Applicant: ( ) -
Fax Number: ( ) -
Your Email Address:
Your World Wide Web Address (If Applicable):
Credit Card Sales Information
What Product or Service are you Selling? (i.e. I sell flowers):
Estimated Average Individual Credit Card Sale Amount: $
Estimated Total Monthly Credit Card Sales: $
Please, If You Remember, Where Did You Hear About Charge.Com?
Please Feel Free to Send Us Any Comments You May Have:
** By Federal Law, All Information Provided Will Remain Confidential **
To become a credit card merchant, click the submit button:
 
Pipeline Data Inc. is a registered ISO/MSP for FDIC insured Wells Fargo Bank, Walnut Creek, CA. American Express and Discover require separate approval.