TRUTH in processing
TRUTH in processing

  ...thinking outside the box since 1995


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Completion of this form does not obligate you to our services. The information you provide will be used to arrive at the best rate program for your business. An account specialist will contact you soon. If you would rather provide your information by phone, please call 307.690.2243.

*Indicates Required Fields
Contact Name*
Contact Email Address*

Business Information

Legal Name of Business
DBA Name (Doing Business As)
Business Structure
Location Address
Business Phone
Web Address
Have you ever accepted Visa/Mastercard?
Number of years in business


Owner/Officer and Title #1

Home Address
Cell #
Please type any special requests or concerns below. You are under no obligation. An account specialist will contact you soon.  
Checking this box is the same as signing your name. By checking this box you are enabling Truth In Processing to write your signature on the documents that pertain only to the merchant service/services your have chosen on this application form.
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