MERCHANT APPLICATION

Use this form to apply for credit card processing services throught Mercury Payment Systems
I authorize LOCFOOD to send this form containing my business and individual information to Mercury Payment Systems, LLC (“Mercury”) for the purpose of pre-applying for card processing and related services. I understand the information in this form will be used by Mercury to begin its underwriting process and is not a guarantee of acceptance which may only occur upon my review and completion of a card services application and agreement and acceptance of same by Mercury and/or its processor and member bank. I authorize Mercury to contact me to provide an application for card processing services and to complete any other steps necessary for completion of a card services application and agreement.
BY MY SUBMISSION OF INFORMATION, I HEREBY AUTHORIZE MERCURY TO OBTAIN AND USE MY INDIVIDUAL AND BUSINESS CREDIT REPORTS AS PART OF ITS UNDERWRITING PROCESS FOR REVIEW OF AN APPLICATION AND ESTABLISHMENT OF A CARD SERVICES AGREEMENT FOR CARD PROCESSING SERVICES. By submitting this form and any supporting documents, I confirm that I have read and agreed to the use of the personal information provided Mercury in accordance with Mercury’s Privacy Policy available at http://www.mercurypay.com/privacy-policy. All information in this form will be treated as confidential and used only in accordance with Mercury’s Privacy Policy.
Mercury’s Merchant Services Provider Contact Information
Name: Mercury Payment Systems, LLC
Address: 150 Mercury Village Drive, Durango CO 81301
Customer Service Phone Number: 800-846-4472
Sales Hours of Operations is Monday through Friday 9:00AM to 5:00PM Mountain Standard Time