United Bank Card -- Part of the United Bank Card Network

Thank you for your interest in United Bank Card's services. Please fill out the pre-application below, and a sales representative in the appropriate department will contact you immediately. The following information is encrypted for your security.

Merchant Account Pre-Application
Company Name:
Contact Name:
Mailing Address:
City, State, Zip:
Product/Service Sold:
Business Phone:
Fax:
Email:

Do you currently accept credit cards?	Yes No
Have you previously taken credit cards?	Yes No

Additional Comments:

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