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Thank you for your referral!

Partnering with Paya process:
  • Complete form below and submit
  • Relationship Manager will contact you within 48 hours
  • Agreement and buy rate pricing will be forwarded to you

    Contact Information

    State*

    Current Processing Information (Optional)

    # of Merchants activated with Credit Card services monthly

    # of Merchants activated with Check and ACH services monthly

    Information About Your Company Needs (Optional)

    Inquiring about
    Check and ACH processingGift & Loyalty Card ProcessingBank Card Processing

    Additional Questions/Comments (Optional)