Merchant Surcharge Form

Merchants who intend to surcharge Visa credit transactions must provide notice directly to Visa and the merchant's acquirer 30 days before beginning to surcharge. Submit the form below to notify Visa of your intent to surcharge along with notifying your acquirer. Additional information about the merchant surcharging guidelines is available here.

For information regarding states that prohibit or limit surcharging, please see surcharging considerations.

* Indicates required field

Merchant Information

 

Sales Channels*
Please select an option.

 

Visa Credit Products to be Surcharged
Other Brands Accepted*

Acquirer / Payment service provider / ISO

Merchant Location Information

For information regarding states that prohibit or limit surcharging, please see surcharging considerations.

Please select your state

 

The information you submit on this page will be used by Visa for internal business purposes and not shared with third parties unless required by law.