Merchants

Submit to SBC 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
		pre app
		DL
		var
		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

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 Fish Island Outfitters LLC 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	May 15 2025 08:05 PM		Alexander Wilkins	Merchant's account was not closed before April so merchant was charged 42.90. Sent cancellation form to SBC for Cancellation and checking regarding refund for April.	-	Alexander Wilkins	May 15 2025 08:25 PM		Update Delete
2	Mar 03 2025 10:13 PM		Charlotte Groff	Spoke to Tony - he sold his business to Crystal Martin. I emailed her a Pre App so that we can get her set up with her own account. I also sent Tony a cancellation request form so we can close his account once she's up and running on her own account.	-		Mar 03 2025 10:45 PM		Update Delete
3	Dec 03 2024 05:23 PM		Alexander Wilkins	Spoke to Tony, merchant has a chargeback. Called SBC and they provided the chargeback notice for the merchant to use.	-		Dec 03 2024 06:12 PM		Update Delete
4	Oct 24 2024 05:58 PM		Alexander Wilkins	Spoke to Tony, was able to get his Pax S80 set up on his new internet via ethernet.	-		Oct 24 2024 09:11 PM		Update Delete
5	Oct 24 2024 05:58 PM		Alexander Wilkins	Spoke to Tony, 3 Military Members were getting their cards declined, terminal printing an Term ID Error. Called Tsys and they stated that on their end it was declined by Visa and recommended that they call bank/card provider for asstance.	-	Alexander Wilkins	Oct 24 2024 06:27 PM		Update Delete
6	Aug 01 2023 12:00 AM			Ethan called and said that they are getting Term ID Error on their terminal. I called TSYS and their V# had been deactivated. Emily emailed Kevin and he said it would take 30 minutes to reactivate it. Let Ethan know it should be working in about half hour.	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
7	Aug 01 2023 12:00 AM			Pin pad not responding. we reset the pin pad now all working	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
8	Aug 01 2023 12:00 AM			TT Tony disabled debit on PAX S80	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
9	Aug 01 2023 12:00 AM		Morgan Withee	User: Morgan Withee -> Notes: updated monthly fee to $29.90 to add 1 ss reader.	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
10	Aug 01 2023 12:00 AM		Mike Thomas	User: Mike Thomas -> Notes: TT Tony walked him through setting up card reader and walked him through a sale and void. All working	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
11	Aug 01 2023 12:00 AM		Mike Thomas	User: Mike Thomas -> Notes: Tried to call Tony to set up card reader...no answer...left voicemail	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
12	Aug 01 2023 12:00 AM		Mike Thomas	User: Mike Thomas -> Notes: TT Tony called to walk him through setting up card reader he wants to do it Monday 4/25/22 at 10:00 am	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
13	Aug 01 2023 12:00 AM		Mike Thomas	User: Mike Thomas -> Notes: Adviserd Tony how to change communication in case internet goes down	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
14	Aug 01 2023 12:00 AM		Morgan Withee	User: Morgan Withee -> Notes: Spoke to Jayson about set up of account. They are going to order a Pax SP 30 pin pad and rent it for $13 a month. I have gone ahead and added the $13 rental to their account. On May 1 they want to add Swipe Simple Bluetooth reader to their account so that they can rent sporting equipment. I put in a reminder to remind me in march	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
15	Aug 01 2023 12:00 AM			User: Charlotte Goff -> Notes: SBC - IBUXX; 3.95%; SwipeSimple Bluetooth Dongle; Merchant has special Terms and Agreements of 30 Day Contract - no ETF	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
16	Aug 01 2023 12:00 AM			User: Charlotte Goff -> Changed : TO Percent FROM 0 TO 10	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
17	Aug 01 2023 12:00 AM			User: Charlotte Goff -> Changed : Swipe Percent FROM 0 TO 90	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
18	Aug 01 2023 12:00 AM			User: Charlotte Goff -> Changed : MonthlyVolume FROM 0.00 TO 15000	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
19	Aug 01 2023 12:00 AM			User: Charlotte Goff -> Changed : AnnualVolume FROM 0 TO 50000	-	Dee Karawadra	Jan 31 2024 01:39 PM		Update Delete
20	Aug 01 2023 12:00 AM			User: Charlotte Goff -> Changed : AverageTicket FROM 0.00 TO 40.00	-	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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