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Reseller Questionaire

Merchant Partners Reseller Questionnaire

Please complete and submit the below form. A Merchant Partners representative will contact you within two business days.

Contact Information
Business Name:
Contact First Name:
Contact Last Name:
Phone Number:
Best Time to Call:
Time Zone:
Fax Number:
Mobile Phone:
Email Address:
Website URL:
Owner / Officer First Name:
Owner / Officer Last Name:
Business Address:
State / Province:
Postal Code:
Business Information
Type of ownership:
Total number of employees:
What are the primary products / services that you sell?:
How long have they been in business?:
Are you a Registered ISO with MC and Visa?:  Check to indicate "Yes" otherwise leave blank
Which Processor(s) do you currently use?:
Which Clearing Bank(s) do you currently use?:
Who are your Key Competitors?:
In what geographic area do you operate?:
What is your total Annual Revenue?:
Total number of accounts in your portfolio:
Annual MC/Visa Volume of Portfolio:
What percentage of risk do you hold on portfolio?:
Percent of Portfolio Card Swipe:
Percent of Portfolio MOTO:
Percent of Portfolio Ecommerce:
Is your existing portfolio portable: Check to indicate "Yes" otherwise leave blank
How many Sales Reps do you have?:
How many New Accounts do you expect to board with us per month?:
Please describe why you feel our companies would be a good fit:
Do you currently accept MasterCard / Visa?: Check to indicate "Yes" otherwise leave blank
Annual MasterCard / Visa Sales Volume:
Merchant Partners services you want to resell

Questions / Comments: