BreakForth! - Ecommerce > Merchant Account Quote Request

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Quote Request
BreakForth! has teamed up with Innovative Merchant Solutions, the world’s premiere transaction services company, to provide you an exceptional value in a merchant account. Fast approval and set-up lets you quickly start making more revenue.

Type of Company:
Products/Services Sold:
Average Transaction Amount:
Anticipated Number of Transactions:		Per Month
Please Rate Your Personal Credit History:

Are you currently accepting Credit Cards?:		Yes No
Current Or Previous Merchant Account With Which Banks:

How do (or will) you sell your products and/or services (please check all that apply):
		Internet/Online Services
		Mail Order
		Phone Order
		Retail Store
		Other:

Notes or Comments:

*Innovative Merchant Solutions - an INTUIT(r) Company is a registered agentof Innovative Bank, Oakland, CA - FDIC Insured