Please fill out this form as completely as possible. However, if there is any information that you do not have available or any question you do not understand, simply leave that section blank, and our staff will help you to obtain the missing information when we process your application.

Remember that all of this information will be kept completely confidential. Discount Credit Card Machine will not share any of your contact information with anyone under any circumstances.

Please make sure that all names and addresses are spelled correctly. This is exactly how they will appear on your merchant account file.