Sentidel :: Application

Wed Mar 10 11:30:18 2010

Thank you for choosing Sentidel

To get started with Sentidel, simply provide the brief bit of information requested below. This will allow us to select which of our teams is best suited to setup your merchant account. Your merchant account specialist team will then contact you by email within 24 hours, introduce themselves, and inform you of what additional information will be required for bank selection and account setup.

We understand the need to be up and running as quickly as possible and we have streamlined our application process to more effectively serve you. Therefore, within two business days of completing your merchant profile, your team will return to you a complete proposal package that fully defines all costs, rates, terms, and protocols of the banks and processors who would be most receptive to your placement.

Additionally, THERE ARE NO FEES OR CHARGES INVOLVED IN THE SENTIDEL APPLICATION PROCESS. It is our privelege to help place your business and to remain a full service partner to your success throughout the life of your account with us.

Business Information

* Company Name

DBA Name

* Business Type

* Entity Type

* Contact Phone

Company Fax

* Company Address

* City

* State/Province

* Postal Code

* Country

* Business Age

(in years)

Tax/EIN Number

Contact Information

* First Name

* Last Name

* Contact Phone

* Contact Email

Nature of Business

* Business Description

Marketing Methods

Processing Method (1)

% Internet Direct (Gateway / Shopping Cart)

(2)

% Card Not Present (e.g. Virtual Terminal)

(3)

% Card Present / Swipe

* Transaction Currency

* Settlement Currency

* Est. Monthly Volume

Avg Transaction

Primary Owner Information

Full Name (Owner)

Title

* Owner Phone

* Years Owned

Passport #

* DOB (YYYY-MM-DD)

Risk Assessment Information

Have the principles or business ever filed for bankruptcy? Yes No

Have the principles or business ever been TERMINATED? Yes No

Do you have a previous or current processing history? Yes No

* What is your refund/cancellation policy?

* How does your customer service work?

* Specify payments options other than credit cards

* List the major countries your clients come from

Describe affilliate programs and their relation to billing

Merchant Website Information

Website URL

Username

Password

Access URL

Additional Information

* By what date do you need this account?

* What is the reason for this placement?

* How did you hear about us?

Please provide any information aboout your business that you feel might assist is in placing your account more easily or effectively

Confirm and Submit

Please enter the verification code in the box below before submitting your application.

Verification Code