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Business Information


Business Location


Owner/Partner/Officer 1 Information

All submitted data is encrypted with HTTPS.
If you do not feel comfortable submitting your SSN, it can be collected when the application is signed.


Owner/Partner/Officer 2 Information

All submitted data is encrypted with HTTPS.
If you do not feel comfortable submitting your SSN, it can be collected when the application is signed.


Transaction Information

Sales Breakdown

Please enter the percentage of sales which are to consumers, businesses, and the government.  The total of all three fields should equal 100%.

Total Percentage: 0.00%

Transaction Types

Please enter the percentage of card transactions which are swiped, keyed, online, or mail order/telephone order (MOTO). The total should equal 100%.

Total Percentage: 0.00%


Final Steps

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