Pre-app Cover Details
Created On
Dec, 13 2023 23:16pm
ID #7490
Pre-app Cover Details
Attached
Required Document Checklist :
Voided check, Business Verification Document, Copy of Drivers License
Merchant
(Business) DBA Name :
Morgan's Bakery
Business Legal Name :
Impact PaySystem
Contact Name :
Morgan Withee
Contact Phone Number :
9016010032
Physical
Address :
1164 Vickery Lane, Suite 200
City :
Cordova
State :
Tennessee
Country :
United States
Zip :
38016
Phone Number :
9016010032
Fax Number :
Email Address :
Website :
Billing Address
Address :
1164 Vickery Lane, Suite 200
City :
Cordova
State :
Tennessee
Country :
United States
Zip :
38016
Business Type
State incorporated in :
Public
Type of Legal Entity :
Sole Proprietor
Business Type :
Business Start Date :
-
EIN/Federal Tax ID Type :
EIN/Federal Tax ID# :
Types of Goods Sold :
Ownership Information
Owner 1
Officer/Owners Name:
Morgan Withee
Title :
Owner
Social Security:
123456789
Home Address:
10080 hwy 194
City :
oakland
State:
TN
Country:
US
Zip:
38016
Drivers License:
1234567899
Issue Date:
Jan, 01 1970
Expiration Date:
Dec, 20 2023
State:
TN
DOB:
Sep, 02 1994
Home Phone Number:
111111111
% of Business Owned :
51
Length of Ownership :
10
Banking Information
Billing Type :
Name of Bank :
Bank
ABA Routing :
111111111
Account :
111111111
Estimated Sales Volume
Estimated Annual Sales Visa/MC/Discover/ AMEX Sales :
$1000000
Estimated Monthly Visa/MC/Discover/ AMEX Sales :
$500000
Average Ticket :
$150
High Ticket :
$1500
Business Profile
Card Swiped :
95%
Card Keyed In :
5% =
100%
Card Present :
95%
Card Not Present :
5% =
100%
Moto :
0%
Internet :
0%
Notes :
Terminal Answer
Batch Out Time :
11:00 AM
Terminal Type :
7
Communication Method :
IP-internet
Do You Dial 9 For Outside Line? :
Yes
Reprogram Terminal :
Equipment Purchase :
Equipment Rental Program :
Next Day Funding :
Tip Edit :
EBT :
FNS Number :
Tax Calculation :
If So Tax Rate :
Refund Policy :
Print Refund Policy On Footer :
Software Or POS Integration Answer
POS Software Integration :
Software Name & Version :
MP/AP Name :
Morgan Withee
RP Name :
Pricing Provided :
Statement Analysis
Receipt Header Message :
Receipt Footer Message :