Merchant Services Application Template

Contents

Legal Business Information

Doing Business As (DBA) Information

Principal Information

Financial Inquiries

Financial Institution References

Trade or Business References

Accepted Card Types

Processing Information

Equipment Options

Schedule of Fees

Requested Documentation to Accompany Completed Application

Merchant Disclosure

Merchant Agreement Acknowledgement

Authorized Signatures

Corporate Certification

This form template is also included in the purchase price of the Merchant Services Program Policy Template.

This form template (approximately 6 pages in Arial Font Size 8 text) is available to purchase from Bankpolicies.com in Microsoft® Word format for a flat fee of $50.00, and you can receive your order via e-mail attachment or on CD-ROM for large volume orders.

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