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
		Application

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

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 Bob's Pawn Shop 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	Apr 21 2025 02:02 PM		Alexander Wilkins	Sent replacement terminal to fix issue. Cards have been going through that do not have enough funding and the S80 is not declining.	-		Apr 23 2025 02:44 PM		Update Delete
2	Apr 02 2025 09:09 PM		Alexander Wilkins	Spoke to the merchant and let them know we are still working on the issue.	-	Alexander Wilkins	Apr 03 2025 02:17 PM		Update Delete
3	Apr 02 2025 09:01 PM		Alexander Wilkins	Rebecca called in stating that their terminal is accepting partial payments. I let her know that the PaxS80s are a bit older so we can take a look and see if we can make it decline partial payments or possibly replace her terminal with a newer one. I will let Mike know in the morning.	-	Alexander Wilkins	Apr 02 2025 09:09 PM		Update Delete
4	Jan 08 2025 06:42 PM		Charlotte Groff	Spoke to Bob - he wanted to add his son's Gary and Craig as contact people on each of his locations. Submitted request to WP via NPCrm SR 61894246	-	Charlotte Groff	Jan 08 2025 06:46 PM		Update Delete
5	Aug 01 2023 12:00 AM		Mike Thomas	User: Mike Thomas -> Notes: Talked to Craig and also sent him an email with all info 11/22/21 concerning new PCI non compliant fees	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
6	Aug 01 2023 12:00 AM		Mike Thomas	User: Mike Thomas -> Notes: TT Kathy turned auto batch off	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
7	Aug 01 2023 12:00 AM		Morgan Withee	User: Morgan Withee -> Notes: Roger Harding called in wants to switch over to PAX S80. I have put in a request for a TSYS Var so we can prepare the equipment	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
8	Aug 01 2023 12:00 AM			User: Aimee Jones -> Notes: Merchant is having connectivity issues. Conferenced her with Vantiv to assist.	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
9	Aug 01 2023 12:00 AM			User: Christina Sullins -> Notes: TT Kim, they had declines on a transaction for $720.75. Wallace in Lvl 2 Helpdesk said it was there once with the auth of 05441Z. Gave Kim the Advanced Products number in case she needs it tomorrow.	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
10	Aug 01 2023 12:00 AM		Mike Thomas	User: Mike Thomas -> Notes: Corrected communications for settlement to dial. Now working.	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
11	Aug 01 2023 12:00 AM			User: Christina Sullins -> Notes: TT Kim, she was unable to settle while on dial back up. The lady in Level 2 Help Desk at Vantiv settled for her and helped her clear the batch out of the terminal.	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
12	Aug 01 2023 12:00 AM		Mike Thomas	User: Mike Thomas -> Notes: TT craig, getting "tampered" on terminal. will need to be replaced. Merchant is calling Roger Harding	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
13	Aug 01 2023 12:00 AM		Mike Thomas	User: Mike Thomas -> Notes: TT Kim, terminal ethernet not working, will need a replacement terminal. Notified Roger Harding.	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
14	Aug 01 2023 12:00 AM		Mike Thomas	User: Mike Thomas -> Notes: Reprogrammed terminal with correct information, ran test....working.	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
15	Aug 01 2023 12:00 AM			User: Christina Sullins -> Notes: Roger Harding programmed the new terminal for this location with the wrong account info. All funds have been going to the Dogwood locations bank account.	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
16	Aug 01 2023 12:00 AM		Mike Thomas	User: Mike Thomas -> Notes: Had NPC remove debit, needs partial download.	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
17	Aug 01 2023 12:00 AM			User: Emily Karawadra -> Notes: Roger asked if debit prompt could be removed. Vantiv confirmed it could I sent request to Mike.	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
18	Aug 01 2023 12:00 AM			User: Emily Karawadra -> Notes: SR# 17429050 SR# 17429100 rate change was requested as they were keyed in wrong into MAG	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
19	Aug 01 2023 12:00 AM		Mike Thomas	User: Mike Thomas -> Notes: Request additional TID for VX520DC	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
20	Aug 01 2023 12:00 AM		Mike Thomas	User: Mike Thomas -> Notes: Needs new terminal, referred to Rodger Harding.	-	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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