Online Merchant Application (Pre-Application)
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Business "DBA" Name (required)

Legal Corporation Name (required)

Business Street Location

City, State, Zip

Local County Name

Ownership Type

Federal Tax ID

Business Phone

Business Fax

Website Address

Business Type

Describe Products Sold

Average Sale Price

Estimated Monthly Volume

Face-To-Face Transactions

Business Start Date

Principal's Name (required)

Principal's Title

Home Address



Zip Code

Years At This Residence

Rent or Own Residence

Ownership Equity

Social Security Number

Driver License Number

Date of Birth

Years Business Ownership

Home Phone

Cell Phone:

Email Address


American Card Systems  | 9858 Glades Road #196, Boca Raton, Florida 33434
Toll Free 866-465-1300   | Fax 866-210-7300 |  Email:

American Card Systems is a registered ISO/MSP of Wells Fargo Bank, N.A., Walnut Creek, CA.
American Express requires separate approval. © Copyright 2009. American Card Systems