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Authorize.net Conversion Info
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Please complete the following required fields to initiate the authorize.net conversion for your account. Most of this information is available in our records and has been included for your convenience. Please review all fields to ensure a quick and smooth transition. You may review the authorize.net privacy policy here.

Learn about the complete conversion process here.

Normal program access will follow completion of the form. Thank You!

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1) The name of your business.
Business Name Required
2) The street address of your business.
Address Required
3) The city in which the business is located.
City Required
4) The two-letter state code of the state where your business is located. Canadian provinces are not allowed.
State Required
5) The U.S. ZIP code of your business.
ZIP Code Required
6) The phone number of the business.
Phone Required
7) The business type.
Business Type Required
8) The business tax ID number. Nine digits and no dashes (-) please!
Tax ID Number Required
9) The number of years in business.
Age of Business Required
10) A valid Standard Industrial Classification (SIC) Code that best describes the business industry type.
SIC Code List
Industry Type Required
11) A brief description of the product(s) and/or service(s) sold.
Products Sold Required
12) Whether or not you intend to use Automated Recurring Billing as part of your business offering.
Recurring Billing Required
13) Whether or not you ship your product(s).
Shipped Goods Required
14) Whether or not you intend to sell your product(s) or service(s) on a subscription basis.
Subscription Sales Required
15) The first and last name of the primary owner or principal of the business.
Principal Account Owner Name Required
16) The primary owner or principals business title.
Title Required
17) The personal Social Security Number of the primary owner or principal. Nine digits and no dashes (-) please!
Social Security Number Required
18) Whether or not you intend to process American Express transactions.
American Express Conditional
19) Whether or not you intend to process Discover transactions.
Discover Conditional
20) The financial institution or Merchant Service Provider (MSP) that provides your merchant account.
Acquirer Required
21) The e-mail address of the primary owner or principal associated with the payment gateway account.
Account Owner E-mail Address Required
22) The name of the bank or financial institution associated with your bank account.
Bank Name Required
23) The nine-digit number that identifies your financial institution.
ABA Routing Number Required
24) The account number associated with a savings or checking account at your business financial institution.
Bank Account Number Required
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