Merchant Pre-Approval Application Form v1.2

Take the first step to accepting credit cards. You can get pre-approved within 24 hours. Please note that there is no charge or obligation by filling out this form.

We will contact you by email once your information is reviewed and start with the bank approval process. If you need any help with filling out the application, feel free to contact us.

:: Business Info / Company Registration Info:

Business/Company Name:
Registration Number:
Address:
City:
ZIP/Post Code:
Country:
Years in Business:

:: Contact Info:

Full Name:
Role/Position Held:
Date of Birth:
E-mail:
Phone:
Fax: (optional)
Skype: (optional)

:: Products / Services Info:

Website(s): Specify one or more URLs of your online business
Business Description: Describe your business in detail
Time of Delivery: Days elapsed until product or service is received by purchaser	Days
Advertising Methods: How do you advertise or sell your products or services
What is your refund policy:

:: Processing Volume Estimates:

Currency this relates to:
Monthly Volume:
Number of transactions per month:
Average transaction value:

:: Processing History & Additional Info:

Accepted Credit Cards Before?
Your Current Processor:
Annual CB Count: If Yes, number of chargebacks in the last 12 months
Annual CB Amount: If Yes, amount/sum of chargebacks in the last 12 months
Merchant Account Terminated? Have you ever had a merchant account agreement terminated?
If Yes, provide full details:
Settlement Currency: Currency you wish to receive payments in
Additional Information: Anything you wish to tell us?

Our Services Overview:

Accept Payments Online By:

Required Documentation:

If you are pre-approved we will ask you for the following scanned copies:

Registration Certificate (If Company)

Business Owner ID / Passport

Recent Home Utility Bill or a personal Bank Account Statement

Optional Documentation:

Beside your basic documentation we may request copies of one or more of the following documents.

Last 4-6 months credit card processing statements from current processor

Copy of a Voided Cheque or a recent Bank Account Statement on your business name

Proof of Domain Name ownership

Website Membership Area logins

Latest business Financials / Tax Returns

Business Plan

Category specific Licenses & Agreements

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CCnetPay LTD
95 Wilton Road, Suite 3
London, SW1V 1BZ
United Kingdom

Skype: ccnetpay [ Chat Now! ]
Phone: +44 (845) 867 9378
Fax: +44 (845) 020 4259
Email: info @ ccnetpay.com