Merchant Application

In order to set up your merchant account you will need to click on "Step 1 of 5" below to get started. Our 5 step application will take about 10 minutes to complete.

Please complete as much information as possible. This will ensure we are able to setup your merchant account in a timely manner. Once you complete the secure form below we will send you a merchant agreement for you to sign.

Once you have completed the form below you will need to fax us the following information:

Copy of Owner/Offier's Drivers License

3 months current merchant account processing statements (if applicable)

Proof of existence (Copy of Business License or Non-Profit 501(c)(3) status letter)

A valid Checking Account and Routing Number (Please attach voided check)

Signed Merchant Agreement by Owner/Officer from your organization

Please fax documents above to 213-402-5997 with CC Setup Documents as Subject Line

Step 2 of 5 - Account Information

Depository Bank:

Bank Contact:

Bank Phone:

ABA Routing Number:

9 digits

DDA Account Number:

Account Type:

Checking

Savings

How are you currently processing (check all that apply)?:

Not currently setup to process Credit or Debit Cards

Virtual Terminal (VT) - Web-based virtual terminal application which performs the processing functions of a physical Point of Sale (POS) processing solution

Mobile Transaction Terminal (MTT) - Combines mobile phone technology with a (POS) terminal

Dial Up Terminal (DUT) - An authorized terminal that (like a telephone) dials the authorization center for validation of transactions

Payment Processing Integrated into Customer Relationship Management Software (CRM) - Process by which organization pushes transactions through a (CRM) software solution to validate transactions (often times a gateway solution such as Authorize.net is used to setup this capability)

Internet Processing - Process by which organizations process transactions online such as an online contribution form, shopping cart, or payment page

Step 3 of 5 - Owner/Officer (s)

Owner First Name: *

Owner Last Name: *

Owner Title: *

Drivers License Number:

DL State:

Home Address:

City:

State:

Zip Code:

Home Phone:

(xxx-xxx-xxxx)

% Ownership: %

If organization is nonprofit place a 0% in this field

Date of Birth: (01-01-65)

Owner/Officer #2 (Optional)

Owner First Name:

Owner Last Name:

Owner Title:

Drivers License Number:

DL State:

Home Address:

City:

State:

Zip Code:

Home Phone:

(xxx-xxx-xxxx)

% Ownership: %

If organization is nonprofit place a 0% in this field

Date of Birth: (01-01-65)

Step 4 of 5 - Merchant Processing Information

Average Ticket Size: $

Monthly Visa/MC Sales: $

Products Sold:

Total Monthly Sales: $

(Including cash & checks)

Visa/MC Sales Profile

Total must equal 100%. Place 0% in those fields not generating sales.

Cards Keyed Face-to-Face: %

Cards Keyed Via Internet: %

Cards Keyed Via MOTO (mail/phone/fax): %

Cards Swiped: %

Ever file bankruptcy?:

Length of Ownership:

Years at Current Location:

Ever Had a Merchant Account?:

Yes

Refund Policy

If other, please explain.:

What is your organization's refund policy?:

30 day money back guarantee

30 day exchange-only

Other

Step 5 of 5 - Choose Pricing Plan

Which rate plans/options best meets your needs as an organization (check all that apply)?:

Low Fees Plan - Discount Rate: 2.39% + Transaction Fee: $0.25 + Statement Fee: $8.00 (Low monthly processing volume)

Best Value Plan - Discount Rate: 2.29% + Transaction Fee: $0.25 + Statement Fee: $12.00 (Medium monthly processing volume)

Low Rates Plan - Discount Rate: 2.19% + Transaction Fee: $0.20 + Statement Fee: $15.00 (High monthly processing volume)

ACH/EFT Plan - Transaction Fee: $0.50 cents + Statement Fee: $10.00

Quote - Please provide me a credit card quote (will need to provide current CC monthly volume levels)

Setup Options (Internal Staff Only)

transactiondepot.com

Merchant Services

Packages

Services