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Thank you for your interest in becoming a Retriever Services merchant. To better understand your needs, we need to ask you a number of questions regarding your business. This Business Information Form incorporates Secure Socket Layer (SSL) encryption to ensure privacy and protection of your personal and business information. Though this is the highest level of security possible, we understand some may still prefer not to provide financial information and other details online.

Contact Us
If you would prefer to speak with a Retriever Services customer service representative directly, please call toll-free (907) 345-8000. Retriever Services customer service representatives are available to assist you Monday - Friday from 9 AM to 9 PM Alaska Standard Time. If you contact Retriever Services after hours, please leave a message and we will return your call the following business day.
*** Retail Processing is available for US locations only. ***
 This field is required indicates a required field.
Company Legal NameThis field is required
 Company DBA("Doing Business As") Name
First NameThis field is required
 Last NameThis field is required
TitleThis field is required
 Web Address
http://
TelephoneThis field is required
 Fax
Company AddressThis field is required

 Email Address
CityThis field is required StateThis field is required Zip CodeThis field is required Country



USA
Date business beganThis field is required
  MM/YYYY
Is your business currently accepting credit cards?This field is required
Yes   No 		If yes, who is your current processor?
Please indicate which services are required: (check all that apply)
Visa
MasterCard
American Express
 Discover Card
JCB
Check Conversion
 Executive One, Alaska
Alaska Rewards
Alaska Benefits
 Gift Cards
Store Charge Card
Point of Sale Terminal
Annual number of Visa/MasterCard transactionsThis field is required
   		Average Ticket/Sales AmountThis field is required
  
Tell us how you wish to process your transactions
 If "Other" please explain
Please describe the Product(s) or Service(s) you sell
 Comments
Are you an existing customer?   Yes   No
Security Code:    
  

© Global Processing, Inc. d/b/a an Independent Sales Agent of Registered ISO/MSP RPSI, Inc. d/b/a Retriever Payment Systems.
700 E 46th Ave. • Suite 200 • Anchorage, Alaska • 99503 • USA. All rights reserved.
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