Pre-app Cover Details
Created On
May, 09 2023 11:00am
ID #4248
Pre-app Cover Details
Attached
Required Document Checklist :
Voided check
Merchant
(Business) DBA Name :
Broken Rose & Co
Business Legal Name :
Alice Hawkins
Contact Name :
Alice Hawkins
Contact Phone Number :
731-610-0790
Physical
Address :
132 Warren Ave
City :
Selmer
State :
TN
Country :
USA
Zip :
38375
Phone Number :
Fax Number :
Email Address :
Website :
Billing Address
Address :
132 Warren Ave
City :
Selmer
State :
TN
Country :
USA
Zip :
38375
Business Type
State incorporated in :
Public
Type of Legal Entity :
Business Type :
Business Start Date :
-
EIN/Federal Tax ID Type :
EIN/Federal Tax ID# :
587-07-8575
Types of Goods Sold :
Ownership Information
Owner 1
Officer/Owners Name:
Alice Hawkins
Title :
owner
Social Security:
582078575
Home Address:
276 Pharr Ave
City :
Selmer
State:
TN
Country:
Zip:
38375
Drivers License:
050829341
Issue Date:
Jun, 22 2020
Expiration Date:
Jun, 22 2028
State:
TN
DOB:
May, 31 1950
Home Phone Number:
7316100790
% of Business Owned :
100
Length of Ownership :
Banking Information
Billing Type :
Name of Bank :
Bank of McNairy county
ABA Routing :
084304337
Account :
*****3179
Estimated Sales Volume
Estimated Annual Sales Visa/MC/Discover/ AMEX Sales :
$
Estimated Monthly Visa/MC/Discover/ AMEX Sales :
$3000.00
Average Ticket :
$200.00
High Ticket :
$500.00
Business Profile
Card Swiped :
98%
Card Keyed In :
02% =
100%
Card Present :
0%
Card Not Present :
0% =
0%
Moto :
0%
Internet :
0%
-
Notes :
Terminal Answer
Batch Out Time :
11:00 AM
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 :