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CardConnect Network
Merchant Information Form

Please complete and submit this form.  A representative will contact you shortly to complete the merchant application process

Or call us! 888-222-8032
(M - F 8 AM - 5 PM Pacific)
Your business must be located in the U.S.A.

Business Information

    Your legal name is the name you use to file your income tax return.
    This must be the actual physical location of your business and where credit card sales are made.
    This is usually the owner's name, but if you are filling out this application for the owner, put your name here.
    Your DBA is the name you want your customers to see on their receipt and on their credit card statement.
    Your mailing address is where we will mail your monthly statements and other important documents.
    Think a bit into the future, say 6 months. What do you anticipate your total credit card sales will be each month?
    How much is your average single sale? Or how much does a single customer usually spend during each visit to your business?

    Do you have a credit card machine? Do you have a POS system? Credit card software? Please provide the make and model.

    Owner/Principal Information


    The information you provide on this form will be kept strictly confidential and will only be used to prepare the appropriate merchant account documents that will be sent to you for your approval via secure link.

    Questions?  Call Us!  888-222-8032
Submit

  • CardConnect SCal is an independent sales agent for CardConnect. All trademarks, service marks and trade names referenced in this material are the property of their respective owners. The CardConnect name and logo are owned by CardConnect LLC., a wholly owned subsidiary of First Data Corporation. CardConnect is a registered ISO of Wells Fargo Bank, N.A., Concord, CA. and Synovus Bank, USA, Columbus, GA. *Promotional offer brought to you by CardConnect SCal; call for details. Privacy Policy
  • Home
  • Solutions
    • Solutions 2
    • Clover Station
    • B2B Payment Processing
    • Attract Customers
    • Give Customers Payment Options
    • Protect Customers
    • Parking Revenue
  • Contact
  • About
  • Partner With Us
    • Agent Registration
  • Get Started