New Merchant Application Form

Please fill out the application found below. Once we receive your application an experienced merchant service expert with regards to your industry, business model, and service interests will be assigned to you. They will reach out to introduce themselves and answer any questions you may have. Should you need to speak with someone immediately or if you do not hear from a service expert within one (1) business day, please call our toll free 800 number. We thank you for your interest in Painless Processing and look forward to being your preferred choice for payment processing services..

Company Name*

Full Name*

Business Address 1*

Business Address 2

City*

State*

Zip Code*

Country*

Phone Number*

E-mail Address*

Website URL, if Applicable

Type of Business (Check all that apply)*:

Retail
Mail Order/Telephone Order (MOTO)
E-Commerce
Mobile

Brief description of product or service sold:

If E-Commerce, what type of shopping cart do you use?:

Estimated Monthly Volume*:

Do you need a merchant account (credit card processing)?*

If Yes: Why do you need a merchant account?

If Other:

Are you interested in a Point of Sale System (POS)?*

Are you interested in Point of Banking services?*

Are you interested in check processing services?*

Are you interested in ACH processing services?*

Are you interested in Merchant Cash Advance?*

Do you have any specific questions, topics of conversation, or other information you believe we should be aware of prior to contacting you?

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