Card Connect Form

Card Connect Application Form

Account Setup

First Name

Email

Business Information

Ownership type

DBA Name

Tax Filling Name

Business Start Date

Fax Number

Address Information

Business Address

City

Country

Mailing Address is same as Billing Address

Ownership Information

First Name

Email

Residence Address

Title

SSN

Drivers License Number

Bank Information

Bank Name

Routing Number

Upload your void check

Processing Information

Business Description

Average Monthly

High Ticket Amount

Merchant Services

Pricing Type

Email Quote Provided to management@iashine.com

Document Information

Upload your Quote:  

Upload your Void check:  

Upload your last two months financial statements:

Statement 1   Statement 2

If an organisation is tax exempt please upload your 501 c letter :