OrangePay – Get Started

Merchant Full Name(Required)

The Merchant is the store or business owner who will being accepting payments

Merchant Email Address(Required)

Merchant Phone Number(Required)

Are you a Merchant or Sales Representitive(Required)

I am a Merchant

I am a Sales Representitive

Sales Representitive Code(Required)

Sales Representitive Email(Required)

Business Information

Business Legal Name(Required)

Business DBA Name(Required)

Tax ID(Required)

Type of Business(Required)

Nature of Business(Required)

Business Address(Required)

Business Phone(Required)

Business Email

Transactional Information

Please enter the $ amount below
Ticket refers to each individual transaction

Average Ticket Value(Required)

Highest Ticket Value(Required)

Estimated Monthly Turnover(Required)

Agent Specific Pricing

Would you like to enter pricing for the Merchant now?(Required)

Yes, I will enter pricing now

No, please will the office contact me for assistance

Please complete the box below with the billing structure for this client

Things to conciser
- interchange Plus
- What are the fees
- What are the monthly costs
- What are the costs of the terminals
- What is the rate for cash discounting?

Fee Structure(Required)

Owner Personal Information

Position / Title(Required)

Ownership Percentage(Required)

Date of Birth(Required)

Social Security Number

Is your residential address the same as your business?(Required)

Yes

Residential Address(Required)

Do you have a copy of a void check or bank account letter?(Required)

Yes, upload now

No, I will email it to you

Upload void check / bank account letter(Required)

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 5 MB.

No problem. Once this form has been submitted, we will send you an email. Please check your spam!

Simply reply to the email and attach a copy of your Void Check or Bank Account Confirmation Letter

Owing to you processing more than $1,000,000 per year - we require some further documentation.

Please send us a copy of a 3 month bank statement and a 3 month processing statement (if applicable)

Will you upload these files now?(Required)

Yes, upload now

No, I will email it to you

Upload bank statement and merchant statement(Required)

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 5 MB.

No problem. Once this form has been submitted, we will send you an email. Please check your spam!

Simply reply to the email and attach a copy of your bank statement and merchant processing statement

Where did you hear about OrangePay?(Required)

Google / Search Engine

Facebook/Instagram

Referral from Friend

Agent Called Me

I saw OrangePay in a Store

I am an OrangePay Sales Rep

Other

Optional: Is there anything else you would like to add?

Name

This field is for validation purposes and should be left unchanged.

Merchant Signup

888-622-5729

Business Information

Processing Information

Transactional Information

Agent Specific Pricing

Owner Personal Information