Pre-Approved Within 2 Hours

Merchant Application

Complete the form below to apply for your payment gateway. Pre-approval decisions are issued within 2 hours of submission.

Administrator / Manager's Information

Manager / Owner Name*

Title / Position

Ownership %*

Street Number

Apt # (optional)

Street Name

City

State

Zip Code

Country

Contact Number*

Mobile Number

Email Address*

ID Type

Passport / DL Number

Offshore Address (if applicable)

Customer Service Information

Customer Service Contact Name*

Email Address*

Phone Number

Toll Free / US Phone #

Customer Service Website

Website Information & Compliance

Website URL*

Products / Services

Toll Free Number

Website Email Address

Compliance Checklist

Full description of products/services displayed?

Pricing clearly visible?

Customer service response within two working days?

Company address displayed on website?

Contact details for customer service displayed?

Toll Free number displayed?

Terms and Conditions visible?

Refund, Return & Cancellation policy displayed?

SSL Secured?

Sales generated through outbound telemarketing?

Do you manage your own website?

Processing History

Years in Business*

Previous Processor

Current Processor

Currently Accept Credit Card?

Currently Accept E-Check?

How Did You Hear About Us?

Duration with Previous Processor

Chargeback Ratio (%)

Have You Ever Had a Merchant Account Terminated?

If yes, please provide the reason

Transaction Information

Average Sales Per Month*

Number of Transactions Per Month*

Maximum Ticket Amount*

Minimum Ticket Amount*

Transaction Type Breakdown (%)

Card Present %

Card Not Present %

E-Commerce %

MOTO (Mail/Phone Order) %

Recurring Billing %

Business Operational Information

Briefly describe your business and services*

Describe the order fulfillment process including timeframes*

Fulfillment Method

Delivery Timeframe

Refund / Return Policy

Additional Information

Additional Information (optional)

By submitting this application you authorize eCheckGateway to verify the information provided. Pre-approval decisions are typically issued within 2 hours during business hours.