Full Merchant ApplicationFill out our full merchant application and upload documents First Name Last Name Your Email Your Phone Please leave this field empty. Company Profile Company Name DBA / Trading Name (if different from Company Name) Company Street Address Company City, State, Postal, Country Country of Incorporation —Please choose an option—AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamas, TheBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofColombiaComorosCongoCook IslandsCosta RicaCote d'lvoireCroatiaCubaCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambia, TheGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern CyprusNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint-BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth SudanSpainSri LankaSudanSurinameSvalbardSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Director Profile Name of Primary Director Director Street Address Director City, State, Postal, Country Director Email Director Phone Business Profile Description of products or services Web Site URL(s) Test Username Test Password Customer Support Number Customer Support Email Method of Acceptance (total must add up to 100%) % Web / online sales (e-commerce) % MOTO / call center % Point of Sale (Retail) Target Markets (total must add up to 100%) % USA & Canada % Europe & UK % Asia % Latin America % Other Do you need credit card processing? —Please choose an option—YesNo Do you currently accept credit cards? —Please choose an option—YesNo How long have you been accepting credit cards? Current Payment Service Provider(s) Reason for Change Monthly Credit Card Total Sales Volume (If you are a startup, please use projected figures) USDEURGBP Average Single Transaction USDEURGBP Highest Single Transaction USDEURGBP Do you need eCheck (ACH) processing? —Please choose an option—YesNo Do you currently accept eChecks? —Please choose an option—YesNo How long have you been accepting eChecks? Current Payment Service Provider(s) Reason for Change Monthly eCheck Total Sales Volume (in USD) (If you are a startup, please use projected figures) USD Average Single Transaction USD Highest Single Transaction USD Do you need SEPA direct debit processing? —Please choose an option—YesNo Do you currently accept SEPA direct debit? —Please choose an option—YesNo How long have you been accepting SEPA direct debit? Current Payment Service Provider(s) Reason for Change Monthly SEPA Direct Debit Total Sales Volume (in EUR) (If you are a startup, please use projected figures) EUR Average Single Transaction EUR Highest Single Transaction EUR Do you need local payments processing? —Please choose an option—YesNo Which Countries/Regions are you looking for local payments processing for? Monthly Local Payments Total Sales Volume (If you are a startup, please use projected figures) USDEURGBP Average Single Transaction USDEURGBP Highest Single Transaction USDEURGBP Do you need cryptocurrency processing? —Please choose an option—YesNo Monthly Cryptocurrency Total Sales Volume (If you are a startup, please use projected figures) USDEURGBP Average Single Transaction USDEURGBP Highest Single Transaction USDEURGBP Additional Comments (special requirements, shopping cart or CRM platform used, etc) To help us work on your merchant account without delay, please click Submit below and use the Document Uploader in the next step of the application. Thank you! Δ
