Merchant Pre Qualification Form
Wister
Wisetr Technologies
Type of Business Entity(check one)
Corporation Limited Liability Company S Corporation Partnership Limited Partnership Sole Proprietor
Does the Merchant have any other businesses
with current AdvanceMe contracts? Check one
Yes No
Wifdsfster
Wisetr Technologies
sdfdsfdsfdsf
new delhi
New Delhi
10018
sdfdsfdsfdsf
new delhi
New Delhi
10018
375438753475
3543545345
4564646456
375438753475
Rented Mortgaged Amount : fdsfsdf
4564646456
$304,932423,434399
20 March, 2014
$50,889343
List the total VISA/MasterCard processing volumes from previous four months:
Last Month :

$30,0000 #Tickets:40
Two Months Ago :

$30,0000 #Tickets:40
Three Months Ago :

$30,0000 #Tickets:40
Four Months Ago :

$30,0000 #Tickets:40
Owner/Officer
Primary Contact
Job Title :
sdfdsfdsfdsf
new delhi
New Delhi
10018
10018
 
new delhi
New Delhi
10018
Authorizations
Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. It has survived not only five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum. Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. It has survived not only five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.
Owner / Officer's Name: (Print)
dsadasdsad
Owner / Officer's Signature:
dsadasdsad
Date:
dsadasdsad
Sales Information (To be completed by Sales Representative)
#3454
dsadasd
3535345454
+9998-777-888
test@test.com
Requested working capital amount:
$30,999,9999
Merchant email address:
test.test@gmail.com
Note:
Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book.