Free Statement Analysis Form


Thank you for your interest in Global Merchant Services.
Fill out your information as accurate as possible and someone will contact you during the time of day specified.

 

ARE YOU PAYING TO MUCH ON YOUR VISA/ MASTERCARD OR CHECK PROCESSING TRANSACTIONS?

WANT TO SAVE MONEY ON YOUR CREDIT CARD, DEBIT CARD OR CHECK PROCESSING.

 

 

I am currently interested in:

 

To make multiple selections, hold down the CTRL button while selecting.

 

 

Company and Contact Information

 

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Business Name:
Business Type:
No. of Years in Business:
Business Address 1:
Business Address 2:
City:
State: form Zip Code:
Business Phone:
Business Facsimile:
Alternate Number:
Website Address:
Contact Name:
Contact Phone Number:
Contact E-mail:
        Federal Tax #:
No. of Locations:
Comments: 

 

Sales Information
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Merchant Type:
Products or Services Sold:
Sales Profile: % Swiped
% Manually Keyed
% Mail Order / Internet
Comments: 
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Projected Sales Volume
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Average Credit Card Ticket:   Credit Card Monthly Volume:
 
Average Check Ticket:       Highest Monthly Check Volume:
 
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Merchant Account Information
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Do you currently accept credit cards?
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If so, who is your current card processor of bank?
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Discount Rate %:
 form Transaction Fee:
 form Monthly Min:
 form Statement Fee:
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Are you paying a Flat Fee for Check / ATM Debit Cards or a Discount Rate?
Do you currently have check guarantee?
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If so, who?
Are you in need of an ATM Machine?
Lease      Purchase      Placement
Would you like to SAVE 15% off every equipment, supply and accessory order?
Did you purchase or lease your equipment?
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If leased, how long left?
Comments:
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Miscellaneous Information
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How did you hear about us?
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Sales Office/ Affiliate Name: Reference I.D. Number:

 

Date:

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