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Merchant Information Form
Please complete and submit this form. An Ignite Payments representative will contact you shortly (usually within an hour) to complete the merchant application process.
Call Us Today
888-608-0003
(M-F 8:30 AM to 5:30 PM Pacific)

Business Information

* Indicates required field

Legal Business Name *

Doing Business As *

Physical Address *

Line 1

Line 2

City

State

Zip Code

Country

Mailing Address (if different) *

Line 1

Line 2

City

State

Zip Code

Country

Business Phone *

Business Fax Number *

Business Email *

Principal Contact Name *

First

Last

Principal Contact Email *

Contact Cell Number *

Type of Business (What do you sell?) *

Number of Employees *

Years in Business *

Monthly Dollar Volume *

Average Ticket Size *

Ownership Type *

Owner/Principal Information

Owner/Principal Name *

First

Last

Ownership % *

Cell Phone Number *

Home Address *

Line 1

Line 2

City

State

Zip Code

Country

Title *

Email *

Comment *

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! 1-888-222-8032

Submit

Merchant Information FormPlease complete and submit this form. An Ignite Payments representative will contact you shortly (usually within an hour) to complete the merchant application process.Call Us Today888-608-0003(M-F 8:30 AM to 5:30 PM Pacific)

Merchant Information Form
Please complete and submit this form. An Ignite Payments representative will contact you shortly (usually within an hour) to complete the merchant application process.
Call Us Today
888-608-0003
(M-F 8:30 AM to 5:30 PM Pacific)