Pre-Vet Merchant Services Application

Page One

1. What site or social media initially brought you to this pre-application? *This question is required.

2. Legal Company Name *This question is required.

3. Your Contact Information *This question is required.Please fill out the name of the owner and address of the company

First Name *This question is required.

Last Name *This question is required.

Street Address *This question is required.

Apt/Suite/Office

City

State/Province *This question is required.

Zip/Postal Code *This question is required.

Country *This question is required.

Email Address *This question is required.

Home Phone Number (provide a phone number that is working) *This question is required.

Mobile Phone (provide a phone number that is working) *This question is required.

Business Phone Number (provide the business/customer service phone number located on your website)

Skype handle (please add us to your Skype list for communication purposes by telling us who you are - rapidfinancialsolutions) *This question is required.

URL *This question is required.

4. Your position within the company? *This question is required.

5. How long have you been a business owner running businesses? *This question is required.

6. How many different businesses have you owned including this one? *This question is required.

7. Name & E-mail Address of Owner of Company *This question is required.

Name
E-mail Address

8. What are the citizenships and Country of residence for all the owners of the company? *This question is required.

Space Cell	Owner's Name	Citizenship	Country where owner resides
Owner 1	Owner's Name	Citizenship	Country where owner resides
Owner 2	Owner's Name	Citizenship	Country where owner resides
Owner 3	Owner's Name	Citizenship	Country where owner resides

9. Do you plan to fully disclose all information that can help us make this process run as smoothly as possible? *This question is required.
When people don't disclose information about their company, previous processing banks they've applied to, and the agents they've worked with, this makes not only our job harder, but we start to distrust you. This will hinder us getting you a merchant account.

10. Are you working with other agents to get you a merchant account? *This question is required.

11. Please list the names of the companies or agents. *This question is required.

Agent 1
Agent 2
Agent 3
Agent 4

12. Have you tried to get a solution with other processors/banks? *This question is required.

13. Please list the names of the processors/banks. *This question is required.

Procesor/Bank 1
Procesor/Bank 2
Procesor/Bank 3
Procesor/Bank 4
Procesor/Bank 5