Independent Agent Application - Painless Processing

SSL Secure Application

Please note, the submission of this application does not constitute an agreement between the agent and Painless Processing or its subsidiaries. Those who do not qualify can still submit merchants through our Refer a Merchant program. You will be notified of status within 3 to 5 business days or less. If you have any questions, please email us at info@painlessprocessing.com.

Step 1 of 3

Basic Information
Name*
First Last
Phone Number:*
Email Address:*
Company Name:*

If you are independent and do not have a company, please put your name.
Website:*

About You
How long have you been in merchant services?*
Are you a registered ISO?*
Do you work with high risk merchants?*
How long have you worked with high risk merchants?*
Are you capable of completing the following on your own, without assistance: completing applications, writing rates & fees, collecting required supporting documents & information as requested by underwriting?*
What would you need assistance with?*
Are you ok with our application processing and underwriting teams contacting your merchants on your behalf to assist with the process?*

SSL Secure Application

Step 1 of 3

Basic Information

About You

About Your Business

ABOUT

SERVICES

HIGH RISK INDUSTRIES

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Terpenes Merchant Account & Payment Processing

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