Pre-app Cover Details
Created On
May, 09 2023 11:00am
ID #4237
Pre-app Cover Details
Attached
Required Document Checklist :
Voided check
Merchant
(Business) DBA Name :
LEJEUNE CHIROPRACTIC CLINIC
Business Legal Name :
ROBERT P LEJEUNE
Contact Name :
ROBERT ROBERT
Contact Phone Number :
3379894424
Physical
Address :
610 GUILBEAU RD SUITE A
City :
LAFAYETTE
State :
LA
Country :
USA
Zip :
70506
Phone Number :
Fax Number :
Email Address :
Website :
Drlejeune.com
Billing Address
Address :
610 GUILBEAU RD SUITE A
City :
LAFAYETTE
State :
LA
Country :
USA
Zip :
70506
Business Type
State incorporated in :
Public
Type of Legal Entity :
-
Business Type :
Business Start Date :
-
EIN/Federal Tax ID Type :
EIN/Federal Tax ID# :
72-1333898
Types of Goods Sold :
-
Ownership Information
Banking Information
Billing Type :
Name of Bank :
ABA Routing :
Account :
Estimated Sales Volume
Estimated Annual Sales Visa/MC/Discover/ AMEX Sales :
$144,000.00
Estimated Monthly Visa/MC/Discover/ AMEX Sales :
$12,000.00
Average Ticket :
$50.00
High Ticket :
$500.00
Business Profile
Card Swiped :
90%
Card Keyed In :
0% =
90%
Card Present :
-
Card Not Present :
- =
0%
Moto :
-
Internet :
0%
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 :
-