888-240-2564

Merchant Account Application
 (Please fill out the online application below)

 Once you have decided to sign up for our “Free Credit Card Terminal Placement Program” please fully complete this Merchant Application Worksheet. What we will do with this information that you provide is to transfer it to the original merchant application. We will then fax or email the application to you for your signature. Also included will be a checklist noting each of the items, if any, that we will need to process your application.
 
All Information Provided To Us Will Remain 100% Confidential.

Important: You must be a US citizen, at least 18 years of age and have a Social Security number to be approved.  Your business must be located in the USA and you must have a physical street address. Home addresses qualify as the physical street address if home based business!
OWNERSHIP INFORMATION

Owner Name

Contact Name

E-mail Address

Legal Business Name

Business Street Address


(No P.O. boxes - If home-based, please enter home address)

City

State

 Please enter the 2 digit state abbreviation here

Business Zip Code

Business Phone Number

Cell Phone Number

About Your Business and Products Sold

Product Or Service Sold (Please be specific)

Estimated Average
Credit Card Sale

Estimated Credit Card
Monthly Volume

Web site Address
(If applicable)

Have You Ever Accepted Credit Cards?

What Kind Of Equipment Or Online System Do You Want To Process Your Credit Card Orders (Note: Banks Now Require Transactions To Be Conducted Electronically - Paper processing Is No Longer Available)

Equipment Needs

 I have a terminal, I just need a Merchant Account Please specify terminal type in comments.

 I want to take Advantage of Package 1. Free   Hypercom Terminal with a new merchant account

 I want Package 2 and stop my bad check losses with the free Hypercom T4100 and placement of a check imager.

 I need Package 3 to speed up check out with the Free Hypercom T4100 and placement of the ViVoPay Contactless reader.

I need the Free Wireless Terminal to capture and get qualified transactions

 I want to own my equipment and would like a quote on purchasing or leasing it!

 FREE Internet payment gateway software. I do not swipe most cards.

I would like to increase my sales and customer loyalty with the 100 Free Gift/Loyalty Card Program

If Applicable, What info didn’t we provide that you wish we did?

Additional Comments - Feedback 

 

 

 

 

Total Merchant Services (TMS) is a registered ISO/MSP for
HSBC Bank USA, National Association, Buffalo, NY
888-240-2564