Credit Card Processing Form

Welcome to our Credit Card Processing Pre-Approval Form
This form is not binding. Please fill out the fields below, so that we may be able to contact you regarding your request. Based on this form (including your needs and preferences), we will provide you a credit card processing application --- which you may review and approve, before signing. We guarantee that your data will be kept CONFIDENTIAL and it will not be shared with any other 3rd parties, beyond the scope of this application. And of course, should you change your mind at anytime about starting the process online, our account experts are only one call or email away. Thank you for your interest and we look forward in doing business with you.
Contact Information (step 1 of 10)
Contact Name*
First Last
Preferred Communication Method*
Contact Email*
Contact Phone
Contact Phone
Contact Title
Please select the services that you are interested in:*
Please specify what other TransNet services you are looking for:
How did you hear about us:*
If "other," please specify:*
Referral Name:
Please specify the source of your referral, so that we may properly acknowledge their kind contribution to our growth.
Business Group/ Trade Association:
Please mention the business group or association that you belong to. Thank you.
Member ID #:
Email Offer ID:
Please specify the Offer ID that was provided to you in the email, so that you may benefit from the offer that was extended to you. Thank you.
Coupon/ Offer Code:
Please specify the Coupon/ Offer Code, so that you may benefit from the offer that was extended to you. Thank you.
Event Name:
MID number(s) or Business Name(s) currently with TransNet:

Please note: If you are an existing client, we may be able to speed up the application process for you, as we have your data on file. Please don't hesitate to call us or email us directly, if that is the route you prefer. Thank you for your loyalty and your continued business with us.
Pricing Information
Please note: All the accounts are addressed on a case-by-case basis. Once we receive this completed form from you, one of our account executives will contact you and you will receive additional paperwork, including our pricing offer, which will be customized to your needs and preferences. As mentioned earlier, you may review the entire application, before signing the final agreement. We are available for you every step of the process. Should you prefer direct assistance, please don't hesitate to reach out to us by phone at (844) 329-1136 or write us at ccsales@transnetenterprises.com and we'll take it together from there. Thank you.
Did you receive a proposal or statement analysis from us?*
Would you rather skip the next steps and have someone contact you directly?*
Proposal ID*
Statement Analysis ID*

Business General Information (step 2 out of 10)
Business/ DBA Name*
Website/ URL:
Business Located In:*
Business Address*
Street Address Address Line 2 City State ZIP Code
Business Address*
Street Address Address Line 2 City Province Postal Code
Business Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Headquarters Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Email
- Same as Contact Email
Business Email*
Business Phone
Business Fax
Business Cell
Business Phone
Business Fax
Business Cell

Owner Information (step 4 out of 10)
Name
First Last
Title
Home Address*
Street Address Address Line 2 City State ZIP Code
Home Address*
Street Address Address Line 2 City Province Postal Code
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Home Phone
Social Security No.
Date of Birth*
MM slash DD slash YYYY
Personal Email

Mailing/ Shipping Information (step 6 out of 10)
Will you need paper statements mailed to you?
Where would you like your statements to be mailed to?*
Will you be ordering equipment from TransNet?
Attention:
First Last
Where would you like your equipment to be shipped to?*
Phone
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Shipping Address*
Street Address Address Line 2 City State ZIP Code
Mailing Address*
Street Address Address Line 2 City Province Postal Code
Shipping Address*
Street Address Address Line 2 City Province Postal Code
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Shipping Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Special Instructions for Delivery

POS Information (step 7 out of 10)
Number of Locations*
Number of Terminals*
Are the locations set up differently?*
Sales Environment*
If "other," please specify:*
Will you keep your existing POS?*
Will you have Support from your POS provider?*
Have you contacted anyone at TransNet regarding the new POS?*
What type of POS will you be using?*
POS Description (Make & Model):
If "other," please specify:*
Will you be using Pin Pad(s)?*
Are you interested in EMV-compatible devices?*
Connection Types Available at Your Business
- Internet (IP)
- Dial-Up/ Phone Line(s) only
- Both
Please note: If you will need to connect your equipment to the Internet, you will need an Ethernet cable (terminals are being shipped with phone cables only).
Will your transactions be settled manually?***
** Recommended for tip adjustment.
Auto Close Time*

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Minutes

AM/PM

Step 1 of 10

Welcome to our Credit Card Processing Pre-Approval Form

Contact Information (step 1 of 10)

Pricing Information

Business General Information (step 2 out of 10)

Business Tax Information (step 3 out of 10)

Owner Information (step 4 out of 10)

Banking Information (step 5 out of 10)

Mailing/ Shipping Information (step 6 out of 10)

POS Information (step 7 out of 10)

Credit Card Sales Details (step 8 out of 10)

Payment Processing Services (step 9 out of 10)

Attachments/ Last Notes (step 10 out of 10)

MERCHANT RESOURCES

Contact