APPLICATION

Contact Person :

Family :

Email :

Phone:

Ext

Title

Legal Company Name

DBA's

Established

Country

State or Province

Industry Type

Corporate website

Notes

New Account

Visa

MasterCard

Amex

CUP

Discover

Other

Currencies :

Type of goods sold description :

Address location :

website :

lowest :

highest :

Avg ticket price :

Shipping Policy or link :

Return policy or link :

Location :

Currencies :

Type of goods sold description :

website :

Avg ticket price :

lowest :

highest :

Return policy :

Check List to be provided by PDF & Initialled by sender:
: Corporate Registration Document

:Resolution of Directors authorizing Application

: Corporate ID (2 pieces gov't issued) of Directors or officers of the company

: 2 invoices from suppliers less than 3 months old

: A Bank void check with the cancelled written across

: Most recent processing statements up to 6 months

: A resolution of the Company stating that the Co is in good standing and has no claims against it from the major card carriers by an issuing or acquiring Bank for fraud.