Merchant Services Application and AgreementMerchant Services Application and Agreement • May 14th, 2022
Contract Type FiledMay 14th, 2022MERCHANT INFORMATION DBA / OUTLET NAME CORPORATE NAME (IF DIFFERENT THAN DBA): PHYSlcAL STREET ADDRESS: (NO P.O. BOXES) ADDRESS: CITY STATE ZIP CITY STATE ZIP PHONE: FAX: PHONE: FAX: CUSTOMER SERVICE PHONE NUMBER (REQUIRED FOR ALL MERCHANTS) WEB SITE ADDRESS: (REQUIRED FOR INTERNET MERCHANTS)