Get StartedFill out our pre-qualification form How Did You Hear About Us? ---Word of MouthGoogleFacebookOnline AdOther Other: First Name Last Name Your Email Your Phone Company Name DBA / Trading Name (optional) Company Street Address Company City, State, Postal, Country Country of Incorporation ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamas, TheBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofColombiaComorosCongoCook IslandsCosta RicaCote d'lvoireCroatiaCubaCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambia, TheGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern CyprusNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint-BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth SudanSpainSri LankaSudanSurinameSvalbardSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Description of products or services Web Site URL(s) Test Username Test Password Customer Support Number Customer Support Email Method of Acceptance (must equal 100%) % Web/online sales % MOTO/call center % Swipe/POS Target Markets (must equal 100%) % USA % Europe % Asia % Latin America % Other Do you need credit card processing? ---YesNo Do you currently accept credit cards? ---YesNo How long have you been accepting credit cards? Current Payment Service Provider(s) Reason for Change I can provide 3 months processing statements: ---yesno Monthly Credit Card Total Sales Volume Average Single Transaction Highest Single Transaction (Please include currencies eg USD, EUR, GBP. If you are a startup please use projected figures.) Do you need eCheck (ACH) processing? ---YesNo Do you currently accept eChecks? ---YesNo How long have you been accepting eChecks? Current Payment Service Provider(s) Reason for Change I can provide 3 months processing statements: ---yesno Monthly eCheck Total Sales Volume (in USD) Average Single Transaction Highest Single Transaction (If you are a startup please use projected figures.) Do you need SEPA direct debit processing? ---YesNo Do you currently accept SEPA direct debit? ---YesNo How long have you been accepting SEPA direct debit? Current Payment Service Provider(s) Reason for Change I can provide 3 months processing statements: ---yesno Monthly SEPA Direct Debit Total Sales Volume (in EUR) Average Single Transaction Highest Single Transaction (If you are a startup please use projected figures.) Do you need UnionPay processing? ---YesNo Do you currently accept UnionPay? ---YesNo How long have you been accepting UnionPay? Current Payment Service Provider(s) Reason for Change I can provide 3 months processing statements: ---yesno Monthly UnionPay Total Sales Volume Average Single Transaction Highest Single Transaction (Please include currencies (eg USD, EUR, GBP). If you are a startup please use projected figures.) Do you need Latin America local processing? ---YesNo Monthly Latin American Total Sales Volume (in USD) Average Single Transaction Highest Single Transaction (If you are a startup please use projected figures.) Do you need local bank transfer processing? ---YesNo Monthly Local Bank Transfer Total Sales Volume Average Single Transaction Highest Single Transaction (Please include currencies (eg USD, EUR, GBP). If you are a startup please use projected figures.) Do you need cryptocurrency processing? ---YesNo Monthly Cryptocurrency Total Sales Volume Average Single Transaction Highest Single Transaction (Please include currencies (eg USD, EUR, GBP). If you are a startup please use projected figures.)
