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Input 1 payments

1
Welcome
2
General Information
3
Account Information

Welcome to Input 1 Payments Sign Up!

Let's get you set up so you can start taking safe and secure digital insurance payments at NO COST to your company.

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Company: *
Phone Number: *
Email: *
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General Information

Tell us about your business.

Legal Business Name:
Business Address:
City:
State: *
Zipcode:
Business Phone:
Client Contact Phone:
Client Contact Email:
Business Website URL:
Federal Tax Number:

Account Information

Tell us about your expected transactions.

Do you currently accept Credit Card Payments?:

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What payment platform/provider are you currently using if any?:
What is your expected monthly credit card volume?:
What is your expected number of monthly ACH payments?:
What is your expected average payment amount per transaction?:

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sales@input1.com | (888) 882-2554 x2135