1-518-346-2115 ext 14

1-212-658-9003 fax

 

Request for Information

 
 

Offshore International Merchant Payment Services

    getting started

 

Please provide us some information about your company and merchant processing needs.  An Atlantic Payment business specialist will contact you to discuss your requirements and review the account terms and application process.

* fields are required - please complete

Company Details  

Business name

*
Business web site *
Non-Traditional Category
Product or Service being sold
Has the business or principal ever had a merchant account terminated by a processor or bank? Yes No
   
Contact Details  
Business principal contact name *
Business Telephone 
Contact's email address *
   
Settlement Details  
Expected Monthly Volume Amount *
Sales Transaction Amount Range: Min  to Max
   

Please provide any additional information:

 

 
Copyright © 2002-2008 Atlantic Payment Systems, LLC
P.O. Box 9584, Niskayuna, New York 12309-0584
Telephone: 518-346-2115  Fax: 212-658-9003
Revised: September 02, 2008