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The Lewis Financial Group
Together Everyone Achieves More

    Original hard-copies are required for the processing of your Merchant 
Account Application. The following information is used to get the 
appropriate Forms to you,  All slots with an  *  must be filled.   
First Name *
Last Name *
Business Name *
Business Address *
Business Address 2
City *
State/Province *
Postal/Zip Code *
Country *
Telephone Number *
Email Address *
Type Of Business *
Average Monthly
Charges *
Under $5,000
Over   $5,000
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Last updated on: January 24, 2017
You may rest assured that your information will not be sold, given nor released to anyone. Since we do NOT charge an application or Processing fee, we send you the appropriate Forms based on the information you provide.
  Russell G. Lewis
 (443) 622-0561
Russ Lewis's Home-Business Internet Showcase
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