CrossCheck PreApp

Business Information

DBA Name of Business

Legal Name of Business

Business Address

Business Ownership Type

Business Phone Number

Business Fax Number

Federal Tax ID

Products or Services

Bank Information

Name of Bank

Branch Phone Number

Please provide a copy of a preprinted blank voided check by either
faxing it to 215-489-7880 or email to

Owner Information

Business Owner

Home Street Address

E-Mail Address

Date of Birth

Driver's License Number

We are required by law to attach a Social Security number to each merchant account and will request this info verbally.

Your Current Check Situation

Current Monthly Check Sales $$

Average Check Sale $$

Total Monthly Check Losses $$

Average Returned Check $$

My Current Check Service Is:

Processing Method

To minimize spam please verify that you are a real person and not a robot. Simply type in the field below the password that you see written to the right.