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For a real-time Internet processing merchant account visit AIS TransAct services.

To obtain a credit card merchant account with a POS terminal or PC/MAC software for credit card processing, please complete the FREE application below. If there is any information that you do not have available or any question you do not understand, simply leave that section blank for now.

After you've submitted your application, a Merchant Services Representative will contact you by telephone (typically within one business day) to answer any questions and set up your merchant account.

IMPORTANT:
The bank can only approve your application if you can meet the following requirements. Please do not apply if you cannot meet the following requirements at this time.


	You must be a US citizen, at least 18 years of age.
	Your business must be located in the US and you must have a physical street address.
	You must have a business checking account with a US bank.
	You must have proof of advertising such as brochures of your product/service. If your business is Internet- based you must have your own Web Site. If you need assistance in setting up a Web Site click here
	You must have either corporation papers, a business license, a Federal Tax ID Number or any form of state licensing.

Express Application

Business Information:
Business Name:
Address:
City, State, Zip
Country:	Currently accepting applications for US ONLY
Telephone Number:
Fax Number:
Business Details:
Type of Ownership:
Title:
Percent Mail Order/Internet
Percent Phone Order
Is your business product or service based?	Product Service Both
Explain the type of product or service you provide:
Amount of Average Sale:
Estimated Monthly Volume:
Web Site (URL):
Do you currently have Merchant status with any bank?	Yes No
Contact Information:
First Name:
Last Name:
Home Street Address:
City, State, Zip:
Country:	Currently accepting applications for US ONLY
Email Address:
Date of Birth: mm/dd/yy:
Best Contact Phone:
Best Time To Reach:
Percent Equity Ownership:
How would you rate your credit?
Credit Card Processing Options:
How would you prefer to process your customers' Credit Cards?	Standand Credit Card Terminal PC Software Macintosh Software PLEASE NOTE: For Details On Real-Time Internet Credit Card Processing Click Here
Other Questions:
How soon would you like to get set up with a merchant account?
Will your product be downloadable from the Internet?	Yes No
Are you operating through a drop-ship company?	Yes No
What additional services would you like information on?	Domain Name Registration Web Site Hosting Shopping Cart Software For Your Website Graphic Design & Web Development
How were you referred to AIS? For example, which particular Web Page, Newsgroup, or Search Engine brought you here? If you have any additional comments or questions please enter them here.
Please submit this application only once. Multiple submissions may cause an error in our system and cause your application to be deleted. By pressing "Submit", the applicant authorizes an investigation of the applicant's credit history with various credit reporting and credit bureau agencies for the sole purpose of determining the approval of the applicant for merchant status or equipment leasing. This information is kept strictly confidential and will not be released. American Express and Discover card require separate approval processes. There is no extra charge for the American express application. If you are interested in accepting these cards please inquire when you are contacted a Merchant Services Representative. The application fee cannot be waived if you already own equipment or software or a terminal that you will use with this account. AIS Media Corporation Partner - Denise Maling is a registered Independant Contractor for Humboldt Bank, Eureka CA

AIS Media Corporation Partner - Denise Maling is a registered Independant Contractor for Humboldt Bank, Eureka CA
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