Ardex Technology Merchant Services

Business Details

Company Number

Business Name

Trading Name

Incorporation Status

Address Details

Trading Address

Phone Number

Mailing Address

Same as trading address

Contact Details

Contact name

Position

Contact Email

Contact Phone

Website

Business Information

Business Description

Projected number of transactions per month?

Projected average transaction value?

Percentage of sales future dated

Average number of days to delivery of goods/service?

Does your business current have a Merchant Facility

Have you ever had a Merchant Facility terminated

Directors Details

Directors name

Date of Birth

Banking Details

This will be where funds are settled to and where fees are debited from.

Bank name

Account name

Account Details

Supporting Document

Please provide a PDF copy of your Bank Statement for the settlement account above to ensure there are no delays

File

Choose a PDF file.

Acknowledgement

By submitting this application, you acknowledge the Terms and Conditions and confirm all information provided is accurate.