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Merchant Processing Application

Apply for credit card and ACH processing. Have your Federal Tax ID, owner details, bank account information and your last 3 months of processing statements ready. Fields marked * are required.

1

Business Information

How your business name appears on customer card statements. Max 23 characters.

Location address

Legal address

Leave blank if it is the same as your location address.
Mail statements to *

Contact

2

Business Profile

Type of Ownership *
Leave blank if unsure

Processing history

Most recent 3 months' processing statements
Prior bankruptcies? *
Have you ever been terminated from accepting bankcards? *
In the last 2 years, have you been placed on a card brand chargeback monitoring program or high-risk list (e.g., the Mastercard MATCH list)? *
3

Processing Profile

Credit card processing volumes and how you take payments.

Sales method

Percentages must total 100%.

Visa / Mastercard / Discover

American Express

American Express marketing
4

ACH Processing

Optional. For businesses that also want to accept bank transfers (ACH).

Do you also need ACH processing?
5

Processing Details

Required for card-not-present sales (online, phone or mail order).

What is the delivery timeframe to the consumer? *
Who owns the product? *
Are consumers required to provide a deposit? *
Is any portion of the deposit refundable?

How far in advance do you take payments?

Example: 20% taken 30 days before delivery. Leave blank if payment is taken at the time of sale.
Will the product be marketed or sold outside of the U.S.? *
How do you advertise? *
Is your business seasonal? *
6

Principals / Beneficial Owners

List every person or entity that owns 25% or more of the company, directly or indirectly. This is used only for identity verification (Know Your Customer). If a credit check is run, it is only on the person(s) signing the application.

Owner 1

Controlling person

Someone with significant management responsibility (CEO, CFO, President, VP, etc.). Skip if this is Owner 1.
7

Bank Information

Account for deposits

Account for fee debits

Only if different from your deposit account.
Voided check or bank letter *
8

Equipment

Tell us what you use today, or what you need.

Terminal / POS

Need equipment?
Gateway / Cloud POS
Do you already have a mobile swiper / chip reader?
9

Review & Sign

Acknowledgements *

Owner / officer signatures

Owner/Officer Signature #1 * Clear
Sign here
Owner/Officer Signature #2 (if applicable) Clear
Sign here

Personal guarantee

[INSERT YOUR PROCESSOR’S PERSONAL GUARANTY TERMS]
Guarantor Signature #1 * Clear
Sign here
Guarantor Signature #2 (if applicable) Clear
Sign here

By submitting, you confirm the information above is accurate and authorize FCL Business Services and its processing partners to verify it, including obtaining credit reports on the signing owner(s). Processing is subject to approval by the processor and sponsor bank. [INSERT YOUR PROCESSOR'S REQUIRED DISCLOSURES, AGREEMENT LINKS AND PERSONAL GUARANTY TERMS]