Processor Selection
Processor


DBA Data
Dba Name
DBA Address1
DBA Address2
DBA City
DBA State
DBA Postal Code
DBA Email
DBA Website
DBA Phone Number
DBA Fax Number
DBA Federal Tax ID
Mcc Code
Contact First Name
Contact Last Name
Merchant Time Zone


Legal Data
Legal Name
Legal Address1
Legal Address2
Legal City
Legal State
Legal Postal Code


Primary Owner First Name
Primary Owner Last Name
Primary Owner Address1
Primary Owner Address2
Primary Owner City
Primary Owner State
Primary Owner Postal Code
Primary Owner Phone Number
Primary Owner Social Security Number
Primary Date of Birth
Primary Driver Lic. Number
Primary Driver Lic. State


Secondary Owner First Name
Secondary Owner Last Name
Secondary Owner Address1
Secondary Owner Address2
Secondary Owner City
Secondary Owner State
Secondary Owner Postal Code
Secondary Owner Phone Number
Secondary Social Security Number
Secondary Date of Birth
Secondary Driver Lic. Number
Secondary Driver Lic. State


Credit Card Processing
Pricing Plan




InterChange Passthough Percentage
InterChange Passthough Per Item




Tiered 3 Qualified Percent
Tiered 3 Qualified Per Item
Tiered 3 Mid Qualified Percent
Tiered 3 Mid Qualified Per Item
Tiered 3 Non Qualified Percentage
Tiered 3 Non Qualified Per Item


ISO Sales Office


Fees
Ach Reject Fee
25.00
Amex Transaction Fee
Annual Fee
Application Fee
AVS Fee
Batch Fee
ChargeBack Fee
25.00
DebitSwitchFee
Debit Transaction Fee
Early Termination Fee
Gateway Fee
Merchant Portal Fee
Monthly Service Fee
Monthly Minimum Fee
Non PCI Monthly Fee
59.95
PCI Monthly Fee
Regulatory Compliance Fee
Retrieval Fee
15.00
Tin MisMatch Fee
Visa Mestercard Discover Amex Auth Fee
Voice Auth Fee
Voice Operator Auth Fee


Merchant Application Information
Years in Business
Merchant Seasonal
Next Day Funding
Daily Discount
Max Ticket
Average Ticket
Monthly Volume
Swipe Percentage
Mail Phone Percentage
Keyed Percentage
Internet Percentage


Bank Data
Name On Bank Account
Account Number
Routing Number
Bank Name


Business Data
Method of Acceptence
Type Of Business
Type Of OwnerShip
Product/Service Sold


Terminal 1