866-460-3478

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

Fill out our No Fee and No Obligation Form Below - this is your first step to accepting credit cards.  Please fill out the form as completely and as accurately as possible.  Please spell the names and addresses you enter on this form correctly.  They will appear on your merchant account exactly as you spell them here.
 
Note: 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   Verifone Terminal with a new merchant account

 I want Package 2 and stop my bad check losses with the free Verifone Vx570 and placement of a check imager.

 I need Package 3 to speed up check out with the Free Verifone Vx570 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?

 If you have any additional  comments or questions please enter them here. We really  appreciate the time you took and the feedback we get. 

 

 

 

 
North American Bancard is a registered Independent Sales Organization/Merchant Service Provider for HSBC Bank USA, National Association, Buffalo, NY and Wells Fargo Bank, N.A.,Walnut Creek, CA