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Business Name
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Phone Number
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Please enter a valid phone number.
Email
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example@example.com
Website
*
Contact Name
*
First Name
Last Name
What does your business sell?
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Time in business?
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Are you a US citizen?
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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?
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Max ticket size?
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Have you ever been on the MATCH list?
Have you ever had a payment processing account terminated? If yes, why?
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