Preliminary Application (Step 1)

If you have any questions about completing an application for merchant services, we're ready to help. You may reach us directly by phone at 207-669-5958 or by email.

Submitting this preliminary application is the first step in creating your merchant services account, but it does not obligate you in any way. Thank you for choosing AcceptCards.net, an authorized agent of PowerPay Merchant Services.

* required fields.

Company

DBA (Company Name): *

Legal Business Name: *

Location Address: *

Location City: *

Location State: *

Location Zip: *

Mailing Address

Mailing Address: *

Mailing City: *

Mailing State: *

Mailing Zip: *

Other Contact Information

Company Phone: *

Fax:

Website:

Email: *

Business Profile

Business Structure: *

Year Business Was Started: *

Ownership/Officers

First Name: *

Last Name: *

Title:*

Ownership %:*