Application Form | Best Merchant Rates

Owner Information

Owner Name*

First Last

Owner Email*

We will never sell or share your information.

Owner Address*

Street Address City State ZIP Code

Owner Phone #*

Owner Birthday*

MM

DD

YYYY

Social Security #*

Why do I need to give you my SSN? The bank requires every account to have an owner attached to it. Please enter SSN without dashes.

Driver's License

Please provide a scan/image of your driver's license.

Business Information

Legal Business Name*

Doing Business As (DBA)*

Business Type*

Tax ID #*

The 9-digit number can be found on your IRS tax return forms. Please enter Tax ID # without dashes.

Phone Number*

Website Address

Business Address*

Same as my address.
Different from my address.

Address*

Street Address City State ZIP Code

Business Start Date*

MM

DD

YYYY

Business Description*

Describe more details about your business.

Processing Information

Please use numbers only.

Average Single Ticket*

This is the average amount that a customer would spend in one transaction.

Highest Expected Ticket*

This is the most a customer would spend in one transaction.

Annual Sales (All Types)*

Total gross sales including cash, check and credit cards.

Annual Credit/Debit Sales*

Total credit and debit cards sales in one year.

Estimate % of Each - Please use numbers only.

% Retail Store/Card Swiped*

Please enter a value between 0 and 100.

% Phone Order/Key Entered*

Please enter a value between 0 and 100.

% Website Shopping Cart/Internet*

Please enter a value between 0 and 100.

Payment Methods

Visa/Mastercard
Discover
American Express

It is free to set up American Express. We pass their fees to you.

Existing American Express Account?

Yes
No

American Express Account Number*

Bank Information

Bank Name*

This is the bank you want your funds deposited into.

Routing Number*

This is a 9-digit number that can be found to the left of your account number on a check.

Account Number*

Voided Check

Please provide a scan/image of a voided business check.

Rates & Fees

Rate

Please enter a value between 0 and 100.

Authorization Fee

Account Fee

Disclosures

Accept 1*

I have reviewed the Merchant Service Program Guide.

Accept 2*

I have reviewed my application and agree to the rates and fees.

Accept 3*

I have reviewed the acceptance and authorization acknowledgement.