Quote
Request Form
Complete for quick
quote review.
An experienced
Sales Representative will contact you within
one business day of the submission of our
online quote request form with a customized
rate plan for credit card processing
services from Pinnacle Processing Group Inc. We respect your
privacy and will never share the information
we collect on our website with any third
parties.
This form contains 28 questions and
typically takes 2 minutes to fill out.
Asterisk (*) indicates required fields.
Contact
Name *
E-mail *
Phone Number *
Alternate Phone
Number
What is the best
time to reach you? *
Do you have any
special requests you would like us to know
about?
Business Name
Street Address
City
State *
Zip
Company Phone
Number
Company Fax
Number
Website Address
Business Type *
Market Type *
Product or Services Being Sold *
Age of Business
Do you currently
accept credit cards? *
If Yes, Name of
Current Processor?
What is your
total monthly sales volume?
What is your
total monthly Bankcard volume? *
What is your
average ticket amount? *
What approximate
percentage of credit cards are keyed in? *
Has the Owner(s)
or Business ever filed bankruptcy?
Are there any
unpaid judgements against the Business or
the Owner(s)?
Is the Business
or the Owner(s) on any national credit card
derogatory file?
