Merchant Account Set-Up

Element Payment Services is a PCI DSS complaint merchant account provider that delivers payment acceptance options designed for you.

Please fill out the form below and an Element payment expert will contact you within 24 hours to answer your processing questions and help you establish your merchant processing account. Element Payment Services will not share your information with any third party; for more information please see our privacy policy.

Merchant Contact Information

Business name:
*Contact first name:
*Contact last name:
*Phone Number:
Cell Phone number:
Fax number:
Email:
Best time to call:

Current Merchant Processing Information

Currently accept credit cards:	YesNo
Current Processor:
Average Ticket:
Monthly credit card volume:

Comments

Please type the two words below in the box provided: *

Element Payment Services Inc. is a registered ISO/MSP with First National Bank of Omaha. © 2010 Element Payment Services, Inc.
Website updated on: 3/11/2010

1.866.435.3636