Merchant Pre-Application

Processing Application Intake Form

Complete all sections accurately. Reviewed by our compliance team before a formal application is sent to you for signature. Fields marked * are required. Once you "save" the application, the "Upload Documents" section will appear, and ALL documents are required for submission.

Business
Owners
Vendor
Processing
Banking
Submit
Documents
General & Business Information
DBA, legal entity, contact & structure
DBA / Location
DBA Name *
DBA Street Address *
City *
State *
ZIP *
Location Phone *
Cust. Service Phone *
Website URL *
Business Email *
Legal / Corporate Must match IRS Tax ID exactly
Legal / Corporate Name *
Legal Address *
Contact Name *
Contact Phone *
Business Started *
Length Owned AUTO
EIN / Tax ID *
Tax Filing Name *
State of Formation *
Business Structure *
Owners / Partners / Officers
All individuals with 25%+ ownership — max 4
Beneficial Ownership: All individuals with 25%+ ownership need to be listed. If multiple owners, the "Control Prong" must be listed in 1st position.
Owner / Officer 1 Primary Signer & Control Prong
First & Last Name *
Title
% Owned
Email *
Phone *
Date of Birth *
Use a unique email per owner, used for e-signature
Home Address — No P.O. Box *
City *
 
State *
 
ZIP *
 
Prior Bankruptcy?
SSN *
DL / ID # *
ID State *
ID Exp. Date *
Required for any individual with 25%+ ownership.
Supply / Fulfillment Vendor
Optional — trade reference, supplier, or fulfillment partner
Please provide one trade reference. A supplier or vendor you work with is acceptable. If you use a fulfillment house, list them as the reference and upload your fulfillment agreement below — otherwise the upload is not required.
Business Name
Contact
Phone
Street Address
City
State
ZIP
Fulfillment Agreement Optional Upload — PDF, DOC, JPG
Nature of Business & Transaction Information
Volume, product description, refund policy
Monthly Volume ($) *
Avg Ticket ($) *
High Ticket ($) *
Days to Delivery
eCommerce %
Card Present %
Not Swiped %
MOTO %
Sales to B2B %
Sales to B2C %
Previous Processor
Reason for Leaving
Prior Security Breach? *
On MATCH / TMF List? *
Description of Products Sold *
Return / Refund Policy *
Banking Account Information
Deposit and fee deduction accounts
Deposit Bank Name *
Routing # *
Account # *
Where Fees Will Be Deducted

Certification & Submission

By submitting this pre-application you certify that all information is true, accurate, and complete, and that your business complies with all website, marketing, and regulatory requirements.

Reviewed within 1 business day. You will be contacted at the email in Section 1. |  cardgroupintl.com

Application Saved - You may continue to enter data.

Noel Ciambotti  |  Card Group International  |  cardgroupintl.com
888-250-2125

Pre-Application Received

Your pre-application has been submitted to Card Group International.

Our compliance team will review and contact you within 1 business day.

Noel Ciambotti  |  Card Group International  |  cardgroupintl.com
888-250-2125