Terminated Merchant Account AKA Terminated Merchant File (TMF) AKA Match List

How were you referred to Terminated Merchant Account:

other

Products/Services you are seeking:

Business Name: *

Contact Name/Title: *

E-mail: *

Phone: *

Cell Phone: *

Business Address:

City:

State:

Zip:

Country:

Phone: *

Fax:

Website:

Are you a startup:
yesno

Age of business:

Products/Services Sold:

How is your product/service sold:

Retail Storefront:

%

Mail Order:

%

Inbound Phone Sales:

%

Outbound Telemarketing:

%

Internet:

%

Current Monthly Volume: $

Projected Monthly Volume:$

Average Credit Card Transaction:$

Highest Credit Card Transaction:$

Have you ever been terminated by a processor before? If YES, please explain in comments box below.
yesno

If so, by what banks/processors?

Who do you currently process with?

What banks/processors have you processed with in the past?

Why are you not with them anymore?

Who have you applied with so far?

How is the signers personal credit?

Credit Score:

Comments:

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