Search
Close this search box.

Complete the Merchant Pre-qualification Form. Provide as much information as possible.

After submitting this form, we will email you a Service Agreement that clearly discloses pricing and other deliverables. Sign and return the DocuSign/Service Agreement as soon as possible.

Type of Corporate Structure (Choose One)
OWNERS and OFFICERS *The person signing this merchant agreement must have at least 51% ownership interest in the company.
ADDITIONAL OWNERS - Are there additional owners? If so, they will need to sign the Service Agreement along with you.
ACH Authorization | Bank Account Deposit Details.
---------------------------------------------------------------------------------------------

Underwriting Profile - Select a box that best describes the type of business profile.
Describe the Methods Used to Capture Sales - Must total 100%
Have you accepted credit card before?
PROVIDE THE NAME OF YOUR WEBSITE BUILDER
TERMS & CONDITIONS OF ACCEPTANCE
This Merchant Account Pre-Qualification form is not a binding contract for service. Information provided in this form allows the ISO and Merchant Services Providers to assess and pre-vet for the applicant for the most suitable product. Furthermore, all information provided in this form is considered private and confidential in nature. Under no circumstances will your data be sold to or shared with any outside party that has no direct involvement in the provisioning of service.

SERVICE DISCLAIMER & LIABILITY WAIVER
Under no circumstances does submission of an application for a merchant account guarantee approval of service. The ISO/sales agent shall will not be held financially responsible nor liable for any costs, fees, business expenses or any losses if an application for a merchant account is declined.

INDEMNIFICATION & WAIVER OF RISK & LIABILITY
Merchant/Applicant agrees to indemnify, defend, and hold harmless KJ Proweb, its officers, directors, agents, employees, and suppliers from and against any lawsuit, claim, liability, loss, penalty or other expense (including attorneys’ fees and cost of defense) they may suffer or incur as a result of a bank or MSPs inability to delivery merchant processing services as described in a Enrollment Application for Service.

If you, the merchant/applicant do not agree with nor accept this Indemnification and Waiver of Liability in its entirety, do not apply for service.
For all inquiries, please feel free to reach out at: