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Comience con AGMS
Business Information
Your Business Name
*
Your Business Phone
*
Your Business Address
City
State
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
Contact Name
Contact Phone
Contact Email
*
Best way to reach you
Business Website
Business Details
What products or services do you sell?
How soon do you need to be processing?
Are you currently accepting credit cards today?
Yes
No
Upload a recent processing statement to expedite the setup process
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Referred By
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Optional Information
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Business Fax
Contact Fax
Type of Business
Sole Proprietor
Partnership
LLC
Private Corporation
Non-Profit/Tax Exempt
Cooperative
Limited Partnership
Other
Refund Policy
No Returns
Exchange
Refund within 30 Days
Other
Are you currently open for business?
Yes
No
Business Location is
Owned
Leased
Owner Name
(if different from contact)
Owner Phone
(if different from contact)
Typical monthly processing volume
(dollars)
Average Sale Amount
(dollars)
What kind of facility does your business operate from?
Retail
Store Front
Tradeshow
Office Building
Other
Will all transactions processed on this account be through websites, software, or apps provided by AGMS?
Yes
No
Notes / Questions
