Merchant Application Quick Setup
Please tell us about your business by completing as much information as possible. Red asterisks are fields that are required before the application can be submitted.
Corporate / Legal Name
*
Name as it appears on your business tax returns. If the business is a Sole Proprietorship it may be the name of the owner.
Merchant Name
*
DBA or Trade Name on your signage or logo
Business Email Address
*
Business Phone Number
*
Please enter a valid phone number.
Business Website Address
*
www.reallygreatbusiness.com - or leave blank if you do not have one
Business Entity Type
*
Please Select
Individual/Sole Prop
Corporation S-Corp
Corporation C-Corp
Non-Profit
LLC/LLP
Partnership
Govt
Other
Please select one.
Business Type
*
Please Select
Retail
Restaurant
Service
Internet/e-commerce
Govt
Lodging
Supermarket
Petroleum
Healthcare
Education
QSR
Charity/Non-Profit
B2B
Other
Please select one.
Please enter your estimated average credit/debit card ticket.
EX: $25.00
Years in business?
*
Please Select
New Business
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10+ Years
15+ years
20+ Years
Estimated Monthly Visa/MC/Discover/Amex Volume
*
Please Select
Less than $5K
$5K - $14,999
$15K - $49,999
$50k +
$100k +
I don't know / unsure
Traditional or Dual Pricing?
Traditional
Dual Pricing
Federal Tax ID
If Sole Prop you may use your social security number.
Business Location Address
*
Street Address
*
Street Address Line 2
*
City
State
*
Zip Code
Business Mailing Address (if different from location address - otherwise leave blank)
Street Address
Street Address Line 2
City
State
Zip Code
Owner / Officer / Partner Name
*
First Name
Last Name
Owner / Officer / Phone Number
*
Please enter a valid phone number.
Owner / Officer / Email Address (if different from above)
*
example@example.com
Owner / Officer / Partner Home Address
*
Street Address
*
Street Address Line 2
*
City
State
*
Zip Code
Date of Birth
*
-
Month
-
Day
Year
Date
Social Security Number
*
Optional on this form, you may submit this information later on the complete application via DocuSign.
Please submit the last three months processing statements if available
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Processing Statements
Please attach a copy of the business license
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please attach a copy a signed bank letter or voided check for deposits
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Business License
Please attach a copy of a signed bank letter or voided check for deposits
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Voided Check or Bank Letter
Please attach a copy of a US Government ID or Drivers License
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Driver's License
Please attach a copy of your menu or inventory if applicable/available
Browse Files
Drag and drop files here
Choose a file
Optional - will help with set up of new HotSauce accounts
Cancel
of
Please make sure you have contacted IT about equipment recommendations, then include equipment type, and quantity.
e.g any additional requirements such as e-commerce, mobile payments, recurring billing, invoicing, online ordering, requests for additional equipment / printers / terminals / virtual terminals/ gift cards or dual pricing
Please provide any additional information or comments you would like us to know.
e.g any additional requirements such as e-commerce, mobile payments, recurring billing, invoicing, online ordering, requests for additional equipment / printers / terminals / virtual terminals/ gift cards or dual pricing
Name of PCBancard Representative
First Name
Last Name
PCBancard representative Email
example@example.com
Select the Compensation Plan for this Deal
Please Select
Fast Start Comp Plan
Residual Plan
Submit Form
PCBancard LLC is a registered ISO of Synovus Bank, Columbus, GA
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