Pre-app Cover Details
Created On
May, 09 2023 11:00am
ID #4194
Pre-app Cover Details
Attached
Required Document Checklist :
Voided check
Merchant
(Business) DBA Name :
Tri State Orthopedics LLC Memphis
Business Legal Name :
Tri State Orthopedics LLC
Contact Name :
Sue Dalal
Contact Phone Number :
901-333-2525
Physical
Address :
1264 Wesley Ave
City :
Memphis
State :
TN
Country :
USA
Zip :
38116
Phone Number :
Fax Number :
Email Address :
Website :
Billing Address
Address :
1264 Wesley Dr.
City :
Memphis
State :
TN
Country :
USA
Zip :
38116
Business Type
State incorporated in :
Public
Type of Legal Entity :
-
Business Type :
Business Start Date :
-
EIN/Federal Tax ID Type :
EIN/Federal Tax ID# :
82-0580917
Types of Goods Sold :
-
Ownership Information
Banking Information
Billing Type :
Name of Bank :
Sun Trust Bank
ABA Routing :
061000104
Account :
1000194651062
Estimated Sales Volume
Estimated Annual Sales Visa/MC/Discover/ AMEX Sales :
$120000.00
Estimated Monthly Visa/MC/Discover/ AMEX Sales :
$10000.00
Average Ticket :
$250.00
High Ticket :
$1500.00
Business Profile
Card Swiped :
80%
Card Keyed In :
20% =
100%
Card Present :
-
Card Not Present :
- =
0%
Moto :
-
Internet :
%
Notes :
-
Terminal Answer
Batch Out Time :
-
Terminal Type :
-
Communication Method :
IP-internet
Do You Dial 9 For Outside Line? :
Yes
Reprogram Terminal :
Yes
Equipment Purchase :
Yes
Equipment Rental Program :
Yes
Next Day Funding :
Yes
Tip Edit :
Yes
EBT :
Yes
FNS Number :
-
Tax Calculation :
Yes
If So Tax Rate :
-
Refund Policy :
30 Days
Print Refund Policy On Footer :
Yes
Software Or POS Integration Answer
POS Software Integration :
-
Software Name & Version :
-
MP/AP Name :
-
RP Name :
-
Pricing Provided :
Statement Analysis
Receipt Header Message :
-
Receipt Footer Message :
-