Merchant Account Inquiry Form

Submit this form if you are seeking a merchant account to allow your business to accept credit cards; or, if you are paying too much for your credit card processing.

Fill out the following form and send to Integrity Payment Systems by clicking on the SUBMIT button at the bottom of the form. When going from field to field on the form do not press the Enter key, use the Tab key or click on the field and then enter your response.

 
Name of Business:
Type of Product or Service:
Contact Name:
Daytime Phone:
Mobile Phone:
Business Address:
City:
State:
Zip Code:
Does Your Business Accept Credit Cards?          
How Did You Hear About Us?
 

If you leave this Merchant Account Inquiry Form to go to another page, you may lose the data you entered.

To print this Inquiry Form, click on your browser's menu bar - File, then Print.

After you click on the "SUBMIT" button, your Merchant Account Inquiry will be electronically transmitted to Integrity Payment Systems. A representative from Integrity Payment Systems will then promptly be in contact with you.