Name *

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What is the Average Rate You or Your Clients are Paying for Traditional Merchant Processing?

1.5% - 2.5%

2.5% - 3.5%

3.5% - 4.5%

4.5%+

On Average What is You or Your Clients Traditional Merchant Processing Monthly Volume?

$10,000 - $25,000

$25,000 - $50,000

$50,000 - $100,000

$100,000+