Created On Nov, 09 2023 19:42pm ID #7464

Pre-app Cover Details

Attached Required Document Checklist :
Voided check
Merchant (Business) DBA Name :
Blue Sky #703
Business Legal Name :
Blue Sky Inc
Contact Name :
Dwayne Temple
Contact Phone Number :
601-684-5641
Physical Address :
2103 Hwy 72 West
City :
Corinth
State :
MS
Country :
Zip :
38834
Phone Number :
Fax Number :
Email Address :
Website :

Billing Address

Address :
PO BOX 1578
City :
Grenada
State :
MS
Country :
Zip :
38901

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 :
Regions
ABA Routing :
065305436
Account :
*****8450

Estimated Sales Volume

Estimated Annual Sales Visa/MC/Discover/ AMEX Sales :
$
Estimated Monthly Visa/MC/Discover/ AMEX Sales :
$170000.00
Average Ticket :
$45.00
High Ticket :
$2500.00

Business Profile

Card Swiped :
95%
Card Keyed In :
5% = 100%
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