Welcome to Merchants Wise Solutions LLC, we have over 12 years of expertise
24th June 2021

09:00 to – 18:00

Monday to Friday

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Credit Card Processing Application

BUSINESS INFORMATION

Business LEGAL Name

Taxpayer Identification Number

E-mail Address

Business DBA

Business Mailing Address

Business Physical Location Address

City

State

Zip

Contact

Business Phone Number

Fax Number

OWNERSHIP / GUARANTOR INFORMATION

Owner / Partner / Officer

Social Security #

Mobile Number (Required)

Home Phone Number

Date of Birth

Home Address

City

State

Zip

MERCHANTPROFILE

Type of Ownership

Sole Proprietorship

Corporation

Limited Liability Company (LLC)

Partnership

Non-Profit

Type of Business

MOTO

Type of Goods and Services Sold

AverageTicket $

MaximumTicket $

Average MonthlyVolume $

Swiped Percentage %

Keyed Percentage %

Have you ever processed payment cards before?

YesNo

If yes, with whom?

Reason for leaving?

Have you ever been terminated by a payment processor?

YesNo

BANK ACCOUNT INFORMATION

Please provide a voided check

Routing Number

Bank Account Number

Bank Name

Bank Phone Number

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