Pre-app Cover Details
Created On
Jun, 12 2025 21:24pm
ID #8059
Pre-app Cover Details
Attached
Required Document Checklist :
-
Merchant
(Business) DBA Name :
Testing Agent App Submission
Business Legal Name :
Testing LLC
Contact Name :
charlotte groff
Contact Phone Number :
9016010032
Physical
Address :
1164 vickery lane
City :
cordova
State :
TN
Country :
Zip :
38016
Phone Number :
9016010032
Fax Number :
Email Address :
Website :
Billing Address
Address :
1164 vickery lane
City :
cordova
State :
TN
Country :
Zip :
38016
Business Type
State incorporated in :
Public
Type of Legal Entity :
LLC
Business Type :
Retail
Business Start Date :
Jan, 14 1995
EIN/Federal Tax ID Type :
Employer Identification Number
EIN/Federal Tax ID# :
987654321
Types of Goods Sold :
misc gifts
Ownership Information
Owner 1
Officer/Owners Name:
John Tester
Title :
w
Social Security:
123456789
Home Address:
1234 TESTING ST
City :
cordova
State:
tn
Country:
Zip:
38016
Drivers License:
55957484
Issue Date:
Jun, 01 2022
Expiration Date:
Jun, 01 2030
State:
TN
DOB:
Sep, 10 1965
Home Phone Number:
9016010032
% of Business Owned :
100
Length of Ownership :
10
Banking Information
Billing Type :
Net Settlement
Name of Bank :
testing bank
ABA Routing :
064000017
Account :
12333333
Estimated Sales Volume
Estimated Annual Sales Visa/MC/Discover/ AMEX Sales :
$25000
Estimated Monthly Visa/MC/Discover/ AMEX Sales :
$2200
Average Ticket :
$25
High Ticket :
$500
Business Profile
Card Swiped :
99%
Card Keyed In :
1% =
100%
Card Present :
0%
Card Not Present :
0% =
0%
Moto :
0%
Internet :
0%
Traditional
Notes :
Terminal Answer
Batch Out Time :
8:00pm
Terminal Type :
Dejavoo
Communication Method :
IP-internet
Do You Dial 9 For Outside Line? :
Yes
Reprogram Terminal :
No
Equipment Purchase :
No
Equipment Rental Program :
Yes
Next Day Funding :
Yes
Tip Edit :
No
EBT :
No
FNS Number :
Tax Calculation :
No
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 :
RP Name :
2131
Pricing Provided :
Statement Analysis
Receipt Header Message :
Receipt Footer Message :
