MERCHANT SERVICES FORM or call: 1-866-757-1524

MERCHANT SERVICES FORM - 1-866-757-1524

We compliment you on your choice to expand your customers’ payment options to include acceptance of credit cards, ATM/debit cards and checks.

With regard to servicing the specific needs of each and every merchant it's important that we know a few things about your business. This information will allow us to give you the best discount rate possible.

Please fill out the form below and a First Data Independent Sales representative will contact you within one business day.

For immediate assistance call: 818-707-1524

Fill out this form completely.
Status
Legal Name
DBA Name
Name
Address 1
Address 2
City
U.S. State
ZIP/Postal Code
E-Mail Address
Day Telephone
Evening Telephone
Contact method	E-Mail Telephone
How did you hear about Cardservice International?

Are you currently accepting credit cards
No Yes
If yes, what type of volume are your currently processing in MasterCard and Visa transactions?

Average ticket:

Method of acceptance?
Point of Sale System:
Are you currently working with a Cardservice International representative?
No Yes-please indicate representative

FDIS Ventura County is an independent agent office of Cardservice International.

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