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Pre-Apply/Inquire Now
Please complete this form to the best of your ability.  This form allows us to match you with the best electronic processing option solution for your business.  If there is a field that you cannot complete or don't understand, leave it blank and we will email you for clarification.  If you have any questions feel free to email info@thompsonmerchant.com or call 912-596-1976 and our available rep will assist you with any questions.  Once you complete this form press the "Submit Data" button below. NOTE: Please be aware that Thompson Merchant Services is NOT a merchant account provider.  We are a business solution provider that can locate the best overall solution based on your business needs.  In the area of credit card processing, we will use our expertise to match you with a registered merchant provider and technology based on your needs.
Processing Product/Service that you're interested in: (This is where you specify the type of service that interests you, or info on whether you have an existing terminal, gateway, or software of your own that you would simply like to have reprogrammed, etc). Not specified by user. If you would like to provide further information please do so here...
MERCHANT INFORMATION
Business Legal Name:   Business/Mailing Address (PO Box is allowed): Business/Mailing City:     Business/Mailing State:  Business/Mailing Zip Code:	Phone (Will appear on customer's statement):   Business Fax:
Merchant "Doing Business As" Name:   Business Start Date:   Is This Business Seasonal?  Total Number of Locations:	Press this button if the physical location (Not a P.O. Box) address is the same as the above mailing address: (Will automatically fill location fields below) Physical Location Address: (If home business enter your home address. Please no P.O. Box)   City:   Location State:   Location Zip:   How Long At This Location?
Contact Name:   Type of Ownership: (Select One) Sole Ownership Partnership Joint Venture LLC Public Corporation Private Corporation Govt. Corporation Non-Profit Other EIN/Federal Tax ID # Contact Phone: (For Merchant Provider Use) Contact Email:	Type of Business: Retail WholeSale Restaurant Lodging Mail Order Telephone Order Covenience Store Convenience Store with Gas Internet Business to Business Home Based Other
Company Web Address/s: (If Applicable)	Products/Services Sold:
Deliver Merchant Statements to: Corporate Headquarters Direct to Business (if different) Deliver Merchant Statements By: Standard Mail Email	Methods of Advertising (Check Any That Apply): Yellow Pages Catalog Direct Mail or Brochure TV or Radio Telephone or Telemarket Newspaper or Magazine Referral Internet or Email
SALES DEPOSIT & REFUND POLICY
% Annual E-Payment Sales (Or Donations) Generated By: Mail/Phone Orders: % Internet Orders: % Card Swipe % Hand Keyed (customer face to face): % Total = 100%	Percentage of customer orders delivered in (if applicable): 0 Days (Same Day): % 1-7 Days: % 8-14 Days % 15-30 Days: % More than 30 Days: % Total = 100%
Number of days to prepare shipments for delivery from date of order: (If Applicable):	Are Customers Required to Provide a Deposit? Yes No If Deposit is required what percentage? %
Do you have a refund policy for your sales? If so what is it? (Ex: Store Credit, Exchange, Card credit, Cash, etc.)
OWNERS/OFFICERS OR REPRESENTATIVES List two owners with the largest share of ownership. Information on the individual(s) signing the application is needed in this section.  (Of course if there is only one owner you may complete the "Officer One" section only.)
NOTE: Social Security Numbers are not required for 501(c)3 Non-Profits that can provide proof of their 501(c)3 status.  You may use your Federal EIN/Tax ID instead.
Owner/Officer/Rep 1.	Owner/Officer/Rep 2 (If Applicable).
Name: Title (Company Title): Date of Birth: (Not Required for Non-Profit Orgs.) Percentage Ownership: Residence Address (physical residence, no P.O. Box) - not required if you're a 501c3 Non-Profit City: State: Zip: Home Phone: How would you define your personal credit? (Helps us set you up on the proper platform which increases chances of approval) - not required if you're a 501c3 Non-Profit I dont have credit Great Good Average - Below 650 Not So Great Poor Have Bankruptcy	Name: Title (Company Title): Date of Birth: (Not Required for Non-Profit Orgs.) Percentage Ownership: Residence Address (physical residence, no P.O. Box) - not required if you're a 501c3 Non-Profit City: State: Zip: Home Phone: How would you define your personal credit? (Helps us set you up on the proper platform which increases chances of approval) - not required if you're a 501c3 Non-Profit I dont have credit Great Good Average - Below 650 Not So Great Poor Have Bankruptcy
Company Lead Officials:
Name of Company President: (If no official president or same as company owner enter owner's name)	Name of Company CFO: (If no official CFO or same as company owner enter owner's name)
SALES VOLUME  INFORMATION (ANTICIPATED)
Annual E-Payment Volume Volume: (Anticipated annual electronic payment volume in dollars)	Average amount per transaction: (Anticipated per transaction amount)
Anticipated total sales or donations: (Anticipated total sales or donations in both electronic payment volume and cash - if you're not aware please provide an anticipated amount)
MAIL OR TELEPHONE ORDER SALES MAIL OR TELEPHONE ORDER SALES (If applicable - not required for 501c3 Non-Profits) Complete if your sales are generated by mail, fax, telephone or internet orders, or if your product is not delivered at the point of sale.   If you're not using a fulfillment house skip this section.  (Note: a fulfillment house is any company that "warehouses" or stock's your products for you then ships them per your request, to keep you from having to stock your own products).
Name if Fulfillment House: (if any) Fulfillment House - Street Address: City: State: Zip:	Delivery Time Frame: (in days) If using a Fulfillment House who owns the inventory: Merchant Fulfillment House
BANK REFERENCES
Bank Name: Bank Address: (If your bank does not have a central branch or location, simply enter the bank address located on your bank statements or checks, bank P.O. Box addresses are fine) Bank City: Bank State: Bank Zip:
TRADE REFERENCES (If applicable)
Company: Products/Services Sold:	Trade Reference Phone: Trade Reference Address:
PROCESSING HISTORY (If applicable)
Current or previous processor Name: (If Applicable) Previous Processor City: State: Zip:	Previous Processor Phone: Processor Contact (If Applicable): Reason for Leaving Processor:
FINALLY: OWNER/OFFICER HISTORY
NOTE: This section is not required for 501(c)3 Non-Profits that can provide proof of their 501(c)3 status.
Have any of the company owners or principals ever filed for bankruptcy? If yes, what is the principal's name. Also what date and what type/chapter.	Have any of the company owners or principals ever owned another business that accepted e-checks, gift cards, debit or credit cards? (If yes, provide business name and principal's name)
Once you're ready to submit the data to TMS click the button below.  Someone will be in touch with you soon after.