Created On May, 23 2023 16:44pm ID #4372

Pre-app Cover Details

Attached Required Document Checklist :
Voided check
Merchant (Business) DBA Name :
Bruce Martin Construction
Business Legal Name :
Bruce Martin Construction
Contact Name :
Paul Fout
Contact Phone Number :
573-379-5776
Physical Address :
242 State Highway T
City :
PORTAGEVILLE
State :
MO
Country :
Zip :
63873
Phone Number :
Fax Number :
Email Address :
Website :

Billing Address

Address :
242 State Highway T
City :
PORTAGEVILLE
State :
MO
Country :
Zip :
63873

Business Type

State incorporated in :
Public
Type of Legal Entity :
Business Type :
Business Start Date :
-
EIN/Federal Tax ID Type :
EIN/Federal Tax ID# :
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 :
$
Estimated Monthly Visa/MC/Discover/ AMEX Sales :
$
Average Ticket :
$
High Ticket :
$

Business Profile

Card Swiped :
0%
Card Keyed In :
0% = 0%
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 :
-

Front Drivers License

Back Drivers License

Video Check