Secure Application

Service Applying For *

Product *

Account Manager / Referral *

How Did You Hear About Us? (copy) *

Credit Card Number (for .01 batch test and service calls on file *

Expiration Date *

CVV *

Business Legal Name *

Business Street Address *

Business City, State, Zip Code *

Business DBA Name (If Applicable) *

Street Address *

City, State, Zip Code *

Business Legal Start Date *

Business Phone Number *

Email *

Confirm Email

Website

Federal ID Number *

Type of Ownership *

Product or Service Your Business Provides

Company Location *

Approximate Square Footage of Business *

Owner / Officer Name *

First

Last

Owner / Officer Title *

Owner Street Address *

City, State, Zip Code *

Owner / Officer Birthdate *

Owner / Officer Social Security Number *

Percentage of Cards Swiped Transactions *

Percentage of Keyed (typed in) Transactions *

*Percentage of Online (Ecommerce) Transactions *

Estimated Amount of Credit Card Sales (Monthly): *

Average Credit Card Sale Amount *

Estimated Maximum Credit Card Sale Amount *

Preferred Auto Batch Time (if applicable)

Additional Notes

* I agree to the terms and conditions. *

I have read and agree to all the terms and conditions in the agreement located @ https://firstclassprocessing.com/terms-and-conditons/. By accepting the terms and conditions and pressing Submit you are providing a digital signature giving First Class Processing limited power of attorney to endorse, edit and submit application(s) to competing lenders on the merchant’s behalf. I agree service terms of $149 hr. for service-related issues unrelated to payment processing. Maintenance Plans and Service Agreements are available and will automatically be renewed annually. Maintenance & Service Agreement can be located at https://firstclassprocessing.com/maintenance-and-service-agreement-waiver/

Digital Signature *

First

Last

By accepting the terms and conditions and pressing Submit you are providing a digital signature giving First Class Processing limited power of attorney to endorse, edit and submit application(s) to competing lenders on the merchant’s behalf.

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Secure Application