Pre-app Cover Details
Created On
Jun, 13 2025 16:14pm
ID #8060
Pre-app Cover Details
Attached
Required Document Checklist :
-
Merchant
(Business) DBA Name :
Testing PreApp Submission Fix
Business Legal Name :
PreApp Submission Fix
Contact Name :
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, 01 2000
EIN/Federal Tax ID Type :
Employer Identification Number
EIN/Federal Tax ID# :
99-1234567
Types of Goods Sold :
misc gifts
Ownership Information
Owner 1
Officer/Owners Name:
John Tester
Title :
w
Social Security:
99-12-3456
Home Address:
1234 Anywhere St
City :
Memphis
State:
TN
Country:
USA
Zip:
38016
Drivers License:
0085497412
Issue Date:
May, 01 2022
Expiration Date:
May, 01 2030
State:
TN
DOB:
Sep, 05 1968
Home Phone Number:
901-601-0032
% of Business Owned :
100
Length of Ownership :
5 Years
Banking Information
Billing Type :
Gross Settlement
Name of Bank :
Tester's Bank
ABA Routing :
064000017
Account :
123456
Estimated Sales Volume
Estimated Annual Sales Visa/MC/Discover/ AMEX Sales :
$30000
Estimated Monthly Visa/MC/Discover/ AMEX Sales :
$2500
Average Ticket :
$30
High Ticket :
$200
Business Profile
Card Swiped :
099%
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 :
None
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 :