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Business Name
*
Contact Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Website
*
What does your business sell?
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Time in business?
*
Are you a US citizen?
*
What countries are your customers located in?
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Are you currently processing? If yes, who is your current processor?
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What is your average monthly processing volume?
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Average chargeback rate over the last 120 days?
*
Max ticket size?
*
Have you ever been on the MATCH list?
Have you ever had a payment processing account terminated? If yes, why?
*
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