Request a Merchant Account Quote

For a free professional review, please fax (770-928-9328) your current bankcard merchant statement to us. A comprehensive written proposal will be presented for your review.

Please complete the following form:

Merchant statements being faxed?	Yes No
Note: Please fax all pages of your current merchant monthly bankcard statement.

Merchant Name:

Type of Business:

Decision Maker:

Contact Phone:

Email Address:

Best time to Call:

Location Address:

City:

State:

Zip:

Fax:	New to Cards:	Yes No
Number of Locations:	Years in Business:
Annual MC/Visa Volume:	Average Ticket:

Special Requirements:

Describe the merchandise sold or services rendered:

Accept AmEx	Yes No	Add AmEx Service	Yes No
Accept Discover	Yes No	Add Discover Service	Yes No
Accept Diners Club	Yes No	Add Diners Club Service	Yes No

Type of Equipment or POS:

Number of units:

Note: maroon label identifies required information

Other Services » PayCard » ATM » Gift & Loyalty » Check Services » EBPP

The Vantage Merchant Account Guarantee
We guarantee personal service, industry expertise, and your complete customer satisfaction.

· No application fee
· No programming fee
· No long-term contract

· No cancellation fee
· No introductory pricing

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