Complete the form below and submit your information to Card Service Professionals for review to accept credit card payments.

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Legal Business Name *

DBA(s)

Address

Address Line 1

Address Line 2

City

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Zip Code

Years at this location

Years in business

Business Phone

Fax Number

Other #

Contact Name *

First

Last

Email *

Website / URL

Type of Company *Sole ProprietorshipPartnership / LP / LLCCorporationGovernmentNon-Profit / Tax Exempt

Max Monthly Volume *

Avg Ticket Amount *

High Ticket Amount *

Terminal/Equipment/Software currently being used (if any)

If leased or under lease what are the terms?

Principal's Name *

Principal's Title

How many years at current address?

Terminal/Equipment/Software currently being used (if any)

Type of Phone LineAnalog / LandlineDigital / VOIPMobile / CellularN/A

Add-Ons

• Add Mobile Terminal?
• Accept American Express?

How did you hear about us?

Do you currently accept Pin-Debit TransactionsNoYes

Is there an External Pin-Pad?N/ANoYes

Describe or link to product return policy

Describe Product(s) or Service(s)

Number of Days until product is delivered

Upload your most recent monthly Merchant Statement if available

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Account RepresentativeVegansAt-RIskDavidJerryJoshLukeNickRebeccaVanessaShanaEvanSiuJonMichael

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ACCEPT ALL MAJOR CREDIT CARDS!

Card Service Professionals, L.L.C. is an Independent Agent of Paysafe Payment Processing Solutions, LLC a, registered Independent Sales Organization/MSP of Deutsche Bank AG, New York, NY; Citizens Bank, N.A., Providence, RI; PNC Bank, N.A., Pittsburgh, PA; Wells Fargo Bank, N.A., Concord, CA; Woodforest National Bank, Houston, TX; BMO Harris Bank, N.A, Chicago, IL; and Merrick Bank, South Jordan, UT.
and
Card Service Professionals, L.L.C., is an Independent Agent of Shift 4 Payments, a registered Independent Sales Organization/MSP of Citizens Bank, N.A.
and
Card Service Professionals, L.L.C., is an Independent Agent of The Credit Wholesale Company, Inc., a registered Independent Sales Organization of Wells Fargo Bank, N.A., Concord, CA.