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Please fill out the following short application below for 100% APPROVAL* for an adult merchant account, pharmacy merchant account, replica merchant account, dating merchant account or a tobacco merchant account and one of our Account Mangers will Respond Back to You within 24 Hours.

IMPORTANT: We DO NOT Respond to Email Inquires from FREE Email Addresses like Hotmail so please reply with email address that is not from a free email account

              ...Less Than Perfect Credit...NO PROBLEM...

At www.safecashier.com less than perfect credit Will Not Stop Us From Approving Your High Risk Merchant Account...but we need to know the details of any credit problems you may have had so we can properly structure your merchant account application  

If you have had a merchant account turned off ( TMF) We Will Still Approve Your Merchant Account unless you lost your merchant account because of credit card fraud.

Business Information:
Business Name	*
Business Address	*
Business Address 2
City	*
State
Zip
Country	*
Business Phone	*
Business Fax
Business Email	*
Website Address	*
Business Type	Please Select Sole Proprietorship Partnership LLC Corporation
Business start date
Please describe the products or Services your business sells
Do you currently accept credit cards?	Yes No
Anticipated cost per item in USD.	*
Anticipated monthly sales in  USD.	*
Owner's Credit	Please Select Excellent Good Fair Poor Bankruptcy DISCHARGED more than 6 months ago Bankruptcy within the past 6 months Non established   *
Contact Information:
First Name	*
Last Name	*
E-mail Address	*
Phone	*
Best time to call	Please Select As soon as possible Morning Afternoon Anytime
Time Zone	Please Select EST CST MST PST Other
How did you find out about High Risk Merchant Accounts?	Please Select AOL Altavista Excite Google GoTo Hotbot Looksmart Lycos MSN Yahoo Word of Mouth Authorize.net's page Your banner somewhere A link on someone's page Radio Ad Magazine Ad Don't remember Other   *
Any additional questions or comments.
Confirmation Code:

*All Merchant Accounts Are 100% Approved provided that our Underwriting Dept approves the content on your site