Welcome to the
CCPS SLIM CD
Merchant Account
Gateway & Shopping Cart

A Great Credit Card Processing Software
Solution


 
 

Merchant Application Worksheet

Now that you have made the decision that the CCPS SLIM CD credit card processing program is right for your business, please complete this worksheet. We will submit your application to underwriting and then you can expect a credit decision in one or two business days. Once your new merchant account is approved we will send you your SLIM CD and then you can start processing credit cards right away.

To begin please fully complete the form below:

Business Information:

Business DBA Name
Legal Name
Address Line 1
Address Line 2
City
State Zip Code

How Many Years at this Address

Date Business Started (MM/YY)

Business Phone Number (Include Area Code)
Business Fax Number (Include Area Code)
Email Address
Web Site (If Applicable)
Federal Tax ID Number (EIN) – Required if Corp. or LLC

Which Legal Category Describes Your Business (Drop Down Menu)


Product or Service Information:

Please Briefly Describe Type of Product / Service Sold

Estimated Monthly MasterCard/Visa $ Volume
Average Ticket
High Ticket

Owner's Information:

Owner’s Full Name
Home Address
City
State Zip Code

How Many Years at this Address

Home Phone Number (Please include area code)

Social Security Number

Date of Birth (Month/Day/Year)

Driver's License Number

Business Reference:

Name of Business
Contact Name
Phone Number (Please include area code)

Personal Reference (Relative or Friend):

Name
Address
City
State Zip Code

Phone Number (Please include area code)

Bank Reference:

Name of Bank
City
State Zip Code

Bank Phone Number (Please include area code)

Routing Number (ABA) – 9 Digits Found on Bottom Left of Check
Checking Account Number

Please fax a copy of a blank check in which you write Void across it to 215-489-7880. You can also scan and email it to Kevin@ccps.biz.

Yes No I would like to purchase manual imprinter. It comes with a pack of 100 sales slips and a MasterCard/Visa decal. The cost is $35.00 + $6.00 shipping.

Comments:

All information is held in the strictest confidence. Thank You.

 


Credit Card Processing Services, Inc.