Easily Collect Payments Online

With Quik.Pay you can collect payments before the customer returns to pick up the car and help them remember you for the great service, not the bill.

Please answer the following questions about your business. You’ll be asked to provide information to verify the business and identity of the primary business contacts. This form should take you about 10 minutes to complete.

Step 1 of 3

- Business Details
  The information you provide below will help us verify and understand your business.
- Business Name*
- Legal Business Name*
  .
- Business Type*
- Industry*
- State of Incorporation*
- Tax ID*
  Employer Identification Number (EIN)
- Date Format: MM slash DD slash YYYY Business Start Date*
- Phone*
- Website
- Primary Email*
- Business Description*
  In a few sentences, describe your customers and the products or services you offer.
- Business Address
- Main Address*
  
  Street Address
  
  Address Line 2
  
  City
  State
  
  ZIP Code

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- Authorized Representative
  Your Quik.Pay account needs to be activated by someone with significant management responsibility or control over your company. If that’s not you, please ask an authorized executive, senior manager, or business owner from your company to complete this form.
- Name*
  
  First
  
  Last
- Title
- Email*
- Work Phone*
- Does this individual own 25% or more of the business?*
  - Yes
  - No
- Is this individual the primary owner?
  - Yes
  - No
- Social Security Number
- Date Format: MM slash DD slash YYYY Birthdate
- Ownership Percent
- Company Ownership Information
  Due to government regulations, we’re required to collect information about a company’s primary owner.
- Name*
  
  First
  
  Last
- Title*
- Email*
- Cell Phone*
- Social Security Number
- Date Format: MM slash DD slash YYYY Birthdate*
- Ownership Percent*
- Home Address*
  
  Street Address
  
  Address Line 2
  
  City
  State
  
  ZIP Code

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- Credit Card Processing
  Tell us about your projected Quik.Pay processing volume.
- Dollars per Month
- Average Transaction Amount
- Max Transaction Amount
- How many stand-alone credit card terminals are being replaced?
- Customer Service Phone*
- Customer Service Email*
- Banking Details for Settlements
  Please provide a checking account that settles in USD ($). Funds are typically disbursed within 1 business days for approved merchants.
- Bank Name*
- Routing Number*
- Account Number*
- Use this account for fees?*
  - Yes
  - No
- Billing Bank Account Details
  Where you want your fees debited
- Billing Bank Name
- Billing Routing Number
- Billing Account Number
- That's it!
  Just upload your recent service department processing statements and consent to the ACH processing terms below.
- *
  I consent to the ACHQ Payment Services Agreement, the Acceptable Use Policy, and the Electronic Signature Terms, and I am providing written instructions under the Fair Credit Reporting Act authorizing ACHQ, to obtain and use information from my personal credit report to process this application.
  
  This inquiry will not affect your credit score.
- Typed Name of Submitter*
- 3 Months Recent Parts and Service Department Credit Card Statements*
  Drop files here or
- Date Format: MM slash DD slash YYYY Date Signed
Email
This field is for validation purposes and should be left unchanged.

Save and Continue Later

Easily Collect Payments Online

With Quik.Pay you can collect payments before the customer returns to pick up the car and help them remember you for the great service, not the bill.

Step 1 of 3

Business Details

Business Address

Authorized Representative

Company Ownership Information

Credit Card Processing

Banking Details for Settlements

Billing Bank Account Details

That's it!