Heartland Merchant Account Form
Currently Processing Credit Cards
List of Needed Information
> DBA Name, Address and Phone Number
> Ownership Setup (LLC, Sole Proprietor, etc.)
> Tax ID
> Sample Contracts; Purchase, Terms, Lease/Payments
> Individual Contact Info (Name, SSN, % Ownership)
> Voided Check
> 1-3 Months Credit Card Processing Statements (If available)
A copy of your responses will be emailed to the address you provided.
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