Security First Merchant Services, LLC

Merchant Service Contact Form

Legal Business Name *
DBA Name *
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Contact *
Phone Number * ### - ### - ####
Fax Number ### - ### - ####
Email *
Business Type *
Sole Propriator Partnership Private Corporation LLC Tax Exempt Organization
Merchant Platform Type *
Internet Wireless Retail Restaurant
Month/Year Established * MM / DD / YYYY
Years at Location *
Monthly Volume in Bankcard Sales *
Average Ticket Sales or Transaction *
1. Please Provide 1 Month Processing Statement if you're an Acceptor of Bankcards
2. Voided Check or Bank Letter Required with all signed Applications for submitting.
Thank You for Choosing Security First Merchant Services, LLC; Enjoy YOUR Day.
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