This is not a working Form.
For demonstration purposes only.
This is not a legally binding agreement. This form gathers information for the purpose of
pre-qualifying an applicant
for a PNC Merchant Account. Any and all informaton obtained
is held in the strictest of confidence and security.
We do not sell information to third parties or mailing lists.
I declare under penalty of perjury under the laws of my State of residence that all
information contained above is true and correct to be best of my knowledge.