Account executive: Faviola Paz
Direct: 213-674-8808
Email: fpaz@paymentcloudinc.com

Online Pre-Application

Business Information

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*(Doing Business As) This will appear on cardholder's statements as the charge
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*What type of product or service do you offer?
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Personal Information

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Number
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Second signer
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Bank Information

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Credit Card Processing

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Average *Average transaction size in USD
Highest *Highest average transaction size in USD

We will not sell or distribute this information to any third parties. This information will be used to submit to the specified bank for the sole purpose of obtaining a merchant account. Your information will not be stored.