Created On May, 09 2023 11:00am ID #4339

Pre-app Cover Details

Attached Required Document Checklist :
Voided check
Merchant (Business) DBA Name :
Gregory E. Reeves O.D
Business Legal Name :
Gregory E. Reeves O.D.
Contact Name :
Cathy Abston
Contact Phone Number :
901-465-3955
Physical Address :
105 E.Market St
City :
Somerville
State :
TN
Country :
USA
Zip :
38068
Phone Number :
Fax Number :
Email Address :
Website :

Billing Address

Address :
105 E.Market St
City :
Somerville
State :
TN
Country :
USA
Zip :
38068

Business Type

State incorporated in :
Public
Type of Legal Entity :
Business Type :
Business Start Date :
-
EIN/Federal Tax ID Type :
EIN/Federal Tax ID# :
409-33-2609
Types of Goods Sold :

Ownership Information

Owner 1

Officer/Owners Name:
Gregory Reeves
Title :
owner
Social Security:
409332609
Home Address:
135 Elm Rd
City :
Somerville
State:
TN
Country:
Zip:
38068
Drivers License:
085118765
Issue Date:
Oct, 22 2014
Expiration Date:
Nov, 17 2019
State:
TN
DOB:
Nov, 17 1979
Home Phone Number:
9012334403
% of Business Owned :
100
Length of Ownership :

Banking Information

Billing Type :
Name of Bank :
Bank of Fayette County
ABA Routing :
084304337
Account :
0030120

Estimated Sales Volume

Estimated Annual Sales Visa/MC/Discover/ AMEX Sales :
$
Estimated Monthly Visa/MC/Discover/ AMEX Sales :
$
Average Ticket :
$250.00
High Ticket :
$1800.00

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 :

Front Drivers License

Back Drivers License

Video Check