Merchant Precheck Form

Merchants can complete the PreCheck form to save time and effort. With the information you provide, we can determine whether we can assist you.

If your PreCheck is approved, we will ask you to proceed and complete our application form.

Merchant Precheck Form

Contracting company name

DBA Name (if applicable)

Email *

Phone *

Company Address *

City *

Zip / Postal Code *

Country of incorporation *

Official Owner / % owned *

Name of CEO *

Years in business *

Merchant business type *

Detailed description of products/services sold *

Describe pricing, membership packages and service lengths *

Is a fulfilment house used

Is a call center used

URL(s) that will be used *

Include login and password if applicable

Username

Password

Current processor

Current Acquirer

How long with current processor/acquirer

Average transaction value

Monthly processing volume

Desired processing currencies

Desired settlement currencies

Transactional History

Sales Volume

Last Month

2 months ago

3 months ago

4 months ago

5 months ago

6 months ago

Number of transactions

Last Month

2 months ago

3 months ago

4 months ago

5 months ago

6 months ago

Chargeback volume

Last Month

2 months ago

3 months ago

4 months ago

5 months ago

6 months ago

Number of chargebacks

Last Month

2 months ago

3 months ago

4 months ago

5 months ago

6 months ago

Refund volume

Last Month

2 months ago

3 months ago

4 months ago

5 months ago

6 months ago

Number of refunds

Last Month

2 months ago

3 months ago

4 months ago

5 months ago

6 months ago

8 + 0 = ? Please prove that you are human by solving the equation *