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

Supported file format is: (Jpg, jpeg, pjpeg, png, x-png, pdf, doc, docx) , upload upto 2 mb file size

File here *	Download	Notes *	Status	Date	Action
		Front Drivers License
		Back Drivers License
		Voided Check
		Business Document 1
		Business Document 2
		Business Document 3

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

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 BLUESTAR GLOBAL TECHNOLOGIES CORPORATION 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

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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

Personal 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

This merchant serves as the exclusive Latin American (LATAM) distributor for The Prometheus Group, a reputable U.S.-based manufacturer of FDA-listed urology and gastroenterology medical devices. The merchant’s core customers are licensed medical professionals, including physicians, clinics, and hospitals, located throughout Latin America and select regions in Europe.

All product inventory is housed at The Prometheus Group’s owned and operated warehouse located in Dover, New Hampshire. There is no use of drop-shipping or third-party fulfillment — all shipments originate directly from this controlled facility, ensuring strict oversight of inventory, fulfillment timelines, and product integrity.

Sales are primarily generated through the merchant's direct participation in reputable U.S.-based medical trade shows. These events are targeted to international, Spanish-speaking healthcare providers who travel to the United States for the express purpose of sourcing certified, U.S.-manufactured medical equipment. All transactions are B2B and involve the sale of FDA-listed medical equipment to verified medical professionals and institutions.

The merchant maintains strict adherence to all relevant export compliance laws and ensures that all buyers are properly licensed. No consumer sales are conducted.

Date

Reminder Date & Time

Employee

Notes

Sr. No.	Date	Reminder Date	Employee	Note	Documents	Created by	Updated at	Updated by	Action
1	Jul 30 2025 04:11 PM		Charlotte Groff	changed DBA name to Prometheus Group LATAM per merchant request. Bluestar Global has exclusive contract with Prometheus Group to only sell their devices and cardholders expect to see Prometheus Group LATAM as the descriptor on their billing statements. Also submitted request to have DBA name changed in SBC and I also changed it in NMI.	-	Charlotte Groff	Jul 30 2025 08:13 PM		Update Delete
2	Jul 18 2025 02:29 PM		Charlotte Groff	SBC Approved but put in High Risk portfolio.	-	Charlotte Groff	Jul 18 2025 02:30 PM		Update Delete
3	Jul 14 2025 09:10 PM		Charlotte Groff	Underwriting is asking for 3 most recent months of processing statements. Processing statements provided only went up to March. Called Agent and requested additional statements.	-	Charlotte Groff	Jul 15 2025 03:44 PM		Update Delete

Application Type

Discount

Business Type

MCC Code

Visa/MC/Discover Rate Category

Base/Qualified (%)

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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 Informationn

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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