Forms

Is there any delay in sending your product or service after receiving payment from your customer for deliveries? If yes, please specify the number of days between payment and delivery *

Forms

Business Contact / Decision Maker : *

Step 2 - Merchant Intake Form

Actual 2023 Terminal Volume ( In Canadian Dollars) *

Business Address : *

Do you accept internet payments ? If so, please provide gateway provider

Business Contact / Decision Maker Telephone *

Do you have a website ? If so please provide URL address

Step 3 - Merchant Quote

Referral Representative *

Projected 2024 Terminal Volume ( in Canadian Dollars) *

Business Contact / Decision Maker Email *

Merchant Intake Form

Referring Partner Name (if any) : *

Business Name: *

Business Tax Number BIN / EIN :

Step 1 - Account Cleared

Maturity Date of Existing Payment Services OR NEW START DATE *

Upload Merchant Statements (last 3 months)