Merchants

Set as Pre-App

Merchant ID*

Legal Name*

DBA Name*

Processor

Agent*

Split*

Is Override*

Password*

Status*

Product Type

Received Date*

Approved Date

Activation Date

Closed Date

Address

Address 2

City

ZIP

Country

State

Contact

Email(comma separated)

Phone

Phone 2

Cell

Fax

URL

DBA Same as Legal Address

Address

City

ZIP

Country

State

Mailing Address Same as DBA

Address

City

ZIP

Country

State

File here *	Download	Notes *	Status	Date	Action
		Signed App

Type*

Deployment Date*

EPI/TPN

Status*

Model*

Purchase T.*

Returned Date

Sales Rep

Serial #

Tracking #

TID

Employee

Purchase Date

Type*

Deployment Date

EPI/TPN

Status*

Model*

Purchase T.*

Returned Date

Sales Rep

Serial #

Tracking #

TID

Employee

Purchase Date

Invoice Number

Invoice Amount

Invoice Status

Send Email to Merchant Send Email to Sales rep Send Email to Employee Delete

Type*

Deployment Date

EPI/TPN

Status*

Model*

Purchase T.*

Returned Date

Sales Rep

Serial #

Tracking #

TID

Employee

Purchase Date

Send Email to Merchant Send Email to Sales rep Send Email to Employee Delete

Bank 1 Information

Bank Name

Account Name

Rounting Number

Account Number

Billing Type

Gross Settlement

Net Settlement

Bank 2 Information

Bank Name

Account Name

Rounting Number

Account Number

Overrides who receive partial commission on all of Kingdom Kids Hair Palace Accounts

Default Setup

Agent 1 Receives

%

on all Newly Inputted Accounts

Agent 2 Receives

%

on all Newly Inputted Accounts

Agent 3 Receives

%

on all Newly Inputted Accounts

Agent 4 Receives

%

on all Newly Inputted Accounts

Processor wise Setup

Select Processor *

Agent 1 Receives

%

on all Newly Inputted Accounts

Agent 2 Receives

%

on all Newly Inputted Accounts

Agent 3 Receives

%

on all Newly Inputted Accounts

Agent 4 Receives

%

on all Newly Inputted Accounts

Select Processor *

Agent 1 Receives

%

on all Newly Inputted Accounts

Agent 2 Receives

%

on all Newly Inputted Accounts

Agent 3 Receives

%

on all Newly Inputted Accounts

Agent 4 Receives

%

on all Newly Inputted Accounts

Merchant *

Month *

Year *

Merchant CMS

EIN/Federal Tax ID Type

MCC Code

EIN/Federal Tax ID #

State incorporated in

Business Start Date

Type of Legal Entity

Business Type

Sub Business Type

Types of Goods Sold

Primary Transaction Type

Card Swiped

%

Card Keyed In

%

Card Present

%

Card Not Present

%

Internet

%

Moto

%

B2B

%

B2C

%

Estimated Annual Sales Visa/MC/Discover/ AMEX Sales

Estimated Monthly Visa/MC/Discover/ AMEX Sales

Average Ticket

High Ticket

Persoanl Guarantor

Telephone Order

%

Discount Method

Refund Policy

30 Days

60 Days

Other

None

Print Refund Policy On Footer
(If Yes Input Message In Notes)

Yes

No

Location Type

Notes

Date

Reminder Date & Time

Employee

Notes

Sr. No.	Date	Reminder Date	Employee	Note	Documents	Created by	Updated at	Updated by	Action
1	Dec 09 2024 08:26 PM		Alexander Wilkins	Sent the merchant the final statement from November. Informed merchant of the final fee and where to send the check to. Currently awaiting info regarding whether or not to wait to send in their cancellation form before they pay.	-		Dec 10 2024 06:52 PM		Update Delete
2	Dec 05 2024 04:47 PM		Alexander Wilkins	Merchant sent in cancellation form, however either there bank blocked billing from PCS or bank account has been closed. Checking with merchant as we cannot close the account until this has been resolved.	-		Dec 09 2024 04:41 PM		Update Delete
3	Dec 05 2024 04:01 PM		Alexander Wilkins	Christy called in, requested cancellation of merchant account.	-		Dec 05 2024 06:18 PM		Update Delete
4	Aug 01 2023 12:00 AM		Morgan Withee	User: Morgan Withee -> Notes: Christy had a question about her billing for $49.50 and $30.40: So I have found out that the $49.50 bill is for the Register fee from May 28-31 which breaks down to $5.15 plus $0.50 tax and then for the month of June the $39.95 plus $3.90 tax. They let me know that you will get a refund since you switched to Register lite on June 7th. That you will get a refund for $24.00 and will hit around June 1st-9th. The $30.40 is the monthly fee for your merchant account. I was also able to figure out that you can log in to your clover dashboard online and on the left-hand side select Account & Set-Up then under Billing Statements select Monthly Statements and this should show you a breakdown of any billing from clover.	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
5	Aug 01 2023 12:00 AM		Morgan Withee	User: Morgan Withee -> Notes: Got their statement returned. There was no suite number on pre app so it was not input on the application. Tricia said suite number is 102. Put in ticket with account updates at PCS to get this corrected.	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
6	Aug 01 2023 12:00 AM			User: Leah Faber -> Changed : TO Percent FROM 0 TO 3	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
7	Aug 01 2023 12:00 AM			User: Leah Faber -> Changed : Swipe Percent FROM 0 TO 97	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
8	Aug 01 2023 12:00 AM			User: Leah Faber -> Changed : AverageTicket FROM 0.00 TO 85	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
9	May 19 2021 12:00 AM	May 19 2021		Christy had a question about her billing for $49.50 and $30.40: So I have found out that the $49.50 bill is for the Register fee from May 28-31 which breaks down to $5.15 plus $0.50 tax and then for the month of June the $39.95 plus $3.90 tax. They let me know that you will get a refund since you switched to Register lite on June 7th. That you will get a refund for $24.00 and will hit around June 1st-9th. The $30.40 is the monthly fee for your merchant account. I was also able to figure out that you can log in to your clover dashboard online and on the left-hand side select Account & Set-Up then under Billing Statements select Monthly Statements and this should show you a breakdown of any billing from clover.	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
10	May 19 2021 12:00 AM	May 19 2021		Got their statement returned. There was no suite number on pre app so it was not input on the application. Tricia said suite number is 102. Put in ticket with account updates at PCS to get this corrected.	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
11	May 19 2021 12:00 AM	May 19 2021		AverageTicket FROM 0.00 TO 85	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
12	May 19 2021 12:00 AM	May 19 2021		Swipe Percent FROM 0 TO 97	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
13	May 19 2021 12:00 AM	May 19 2021		TO Percent FROM 0 TO 3	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete

Application Type

Discount

Business Type

MCC Code

Visa/MC/Discover Rate Category

Base/Qualified (%)

Mid Qualified (%)

Non Qualified (%)

Base Debit- Non Pin Debit(Sig Debit Rate) (%)

Rewards Discount (%)

Statement Fee

Card On File Fee

PCI Fee

Non PCI Compliance

Authorization Fee

Per Item Fee

EBT Fee

FNS/EBT Number

Pin Debit Item Fee

Pin Debit Discount

Amex Opt Blue Rate

Base/Qualified Rate (%)

Mid Qualified Rate (%)

Non Qualified Rate (%)

Program Cost Opt Blue (%)

Authorization Fee

Per Item Fee

Other Monthly Fee

Ancillary Fees

Batch Fee

Retrievel Fee

Chargeback Fee

ACH Change Fee

Voice Auth Fee

Gateway Monthly Fee

Setup Fee

Owner 1 Information

Officer/Owners Name

Title

Social Security

Form of ID

ID #

Issue Date

Expiration Date

State

DOB

Home Phone Number

% of Business Owned

Length of Ownership

Home Address

Home city

Home state

Home country

Home zip

Owner 1 Information

Officer/Owners Name *

Title

Social Security

Form of ID *

ID # *

Issue Date *

Expiration Date *

State *

DOB *

Home Phone Number

% of Business Owned

Length of Ownership

Home Address *

Home city *

Home state *

Home country

Home zip *

Software Or POS Integration Questions Only

POS Software Integration

Yes

No

Software Name & Version:

Pricing Provided

Statement Analysis

Quote

POS Software Publisher

Seasonal Flag

Seasonal Months

Deposit Time Frame

Deposit Type

Network ID

MP/AP Name

RP Name

Receipt Header Message

Receipt Footer Message

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