Pre-app Cover Details
Created On
May, 09 2023 11:00am
ID #491
Pre-app Cover Details
Attached
Required Document Checklist :
Voided check
Merchant
(Business) DBA Name :
East Side Moulding
Business Legal Name :
East Side Moulding
Contact Name :
David Stoltzfus
Contact Phone Number :
717-692-1200
Physical
Address :
City :
State :
Country :
Zip :
Phone Number :
Fax Number :
Email Address :
Website :
Billing Address
Address :
2987 Route 25
City :
MILLERSBURG
State :
PA
Country :
Zip :
17061
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 :
%
Card Keyed In :
% =