No Business is Too Big, Too Small, Too New or Too Old! 98% Approval Rate! Low Fees, Fast Approval, Easy Setup! Apply NOW!
By filling out this form you will not enter in to any agreements or contracts!
Please fill out this form as completely as possible. If there is any information that you do not have available or any question you do not understand, simply leave that section blank, and our staff will help you to obtain the missing information when we process your application. We're here to make sure that your application process is pleasant.
Your business must be located in the USA and you must have a physical street address. Home addresses qualify as the physical street address if home based business! Some restrictions may apply and approval is not guaranteed.
* This form is for US based businesses only. If you have a Non-U.S. based business please check out our international program here: Non US Merchants
Owner 1 Name
Percent Owned
Owner 2 Name
(Leave Blank If Sole Owner
Percent Owned
Contact Name
Email Address
Best Phone Number To Reach
Legal Business Name
Doing Business As (DBA)
Business Street Address
Not a US based business?
Click Here for our Premier International Payment Program
Business Zip Code
Business Country
Business Phone Number
FAX Number
Date The Business Opened (Month/Day/Year)
About Your Business and Products Sold
Product, Service or Merchandise Sold
Type of Business? (Corporation, Partnership, Sole Ownership, etc.)
% Internet Orders
% Mail/Phone Order
% Face To Face (Swiped)
Estimated Average
Credit Card Sale
Estimated Credit Card
Monthly Volume
WWW Site Address
Have You Ever Accepted Credit Cards?
If Yes, Do You Currently Accept Credit Cards?
Which particular search engine brought you here and what search term did you use to find us? Example: Google.com - searching for merchant accounts. Or Which Magazine, Post Card, Friend or Other Advertisement Etc.
How Did You Hear About Us? (* Note: This has to be filled in for the form to work.)
What Kind Of Equipment Or Online System Do You Want To Process Your Credit Card Orders (Note: Banks Now Require Transactions To Be Conducted Electronically-Paper processing Is No Longer Available)
Equipment Needs
Home Address
Not a US based business?
Click Here for our Premier International Payment Program
Zip Code
Home Phone Number
Rent or Own?
What is your credit rating?
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Copyright © Electronic Transfer, Inc. All Rights Reserved. 3107 East Mission Avenue, Spokane WA 99202 - Toll Free (800) 757-5453
Electronic Transfer, Inc. is a registered ISO/MSP of Westamerica Bank, Santa Rosa, CA.. American Express merchant accounts approved separately.
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