Card Processing Systems

Cash Advance Online Application

The 3 Minute Merchant Application Click Here to download the 3 Minute Merchant Application and fill out and fax to us, or fill out the online form below. Thank you.
Merchant Information
Legal Business Name
DBA Name
Physical Address
City	-State -Zip
Business Phone	-Business Fax
Email
Total Monthly Sales (CC & Cash)
Type of Business	-Years in Business
Business Open Date
Time Remaining On Site Lease/Mort
Landlord/Agent Name
Landlord/Agent Phone
Number of Locations
9 digit federal Tax I.D.#
Is your business for sale? Yes No
Amount Requested
Have you ever filed bankruptcy? Yes No
Intended use of cash advance
Do you have any federal or state tax liens? Yes No
Have you previously had a cash advance? Yes No
If yes, please supply payoff confirmation
Is your business seasonable? Yes No
Credit Card Processor Information
Current Processor
Merchant Account Information
Terminal type currently used
Number of terminals at location
Length of time with current processor Years Months
Principle Owner Information
Principal Owner Name
Social Security #
D.O.B.
Home Address
City	-State -Zip
Home Phone	Mobile
% Ownership
How long at home address..
Number of years at previous home address
Estimated Current annual income

2nd Owner Name
Social security #
D.O.B.
Home Address
City	-State -Zip
Home Phone	Mobile
% Ownership
How long at home address..
Number of years at previous home address
Estimated Current annual income

Sale Staff Information
Merchant ID
Sales Person
Partner ID