Cross-Check Pre-App BUSINESS INFORMATION DBA Name of Business * Legal Name of Business* Business Address* Street Address City State / Province / Region Postal / Zip Code Business Ownership TypeSelect valueSole PoprietorPartnershipCorporation Business Phone Number* Business Fax Number Federal Tax ID Products or ServicesBANK INFORMATION Name of Bank* Branch Phone Number*Please provide a copy of a preprinted blank voided check by either faxing it to 215-489-7880 or email to sales@nobouncedchecks.com. OWNER INFORMATION Business Owner* Home Address* Street Address City State / Province / Region Postal / Zip Code E-Mail Address* Date of Birth Driver's License NumberWe are required by law to attach a Social Security number to each merchant account and will request this info verbally.YOUR CURRENT CHECK SITUATION Current Monthly Check Sales $$* Average Check Sale $$ * Total Monthly Check Losses $$* Average Returned Check $$* My Current Check Service Is:* Processing MethodSelect valueI plan to use my own PC and the free CrossCheck virtual terminal along with the free loaner check imager.I would like to purchase a new Ingenico iCT220 terminal and use the free loaner check imager. reCAPTCHASubmitReset