Application | Visioneer Pay

Ready to open an account?

Please fill out the form below. We'll use the information to prepare the appropriate merchant account paperwork that will be sent to you electronically for your approval.

Your business must be located in the U.S.A.

bernese-mountain-dog-puppy-greater-swiss-mountain-dog-border-collie-cat-puppy-18b91315675e

Business Information

Legal Business Name

Doing Business As Name

Business Email

Business Phone

Company Website

Physical Business Address (No PO Boxes)

Physical Business Address Line 2

City

State

Zip code

Mailing Address (if different)

Mailing Address Line 2

City

State

Zip code

Type of Business

Monthly Dollar Volume

Average Ticket Size

Number of Employees

Principal Contact First Name

Date Your Business Started

Principal Contact Last name

Do you already own any credit card equipment? If so, describe what you have.

Additional Comments

The information you provide on this form will be kept strictly confidential and will only be used to prepare the appropriate merchant account documents that will be sent to you for your approval via a secure link.