Created On Jun, 16 2025 06:00am ID #8064

Pre-app Cover Details

Attached Required Document Checklist :
-
Merchant (Business) DBA Name :
Neil Lou
Business Legal Name :
wwww
Contact Name :
Neil Lou
Contact Phone Number :
2172592400
Physical Address :
1164 Vickery LaneSuite200
City :
Cordova
State :
TN
Country :
United States
Zip :
38016
Phone Number :
Fax Number :
Email Address :
Website :

Billing Address

Address :
1164 Vickery LaneSuite200
City :
Cordova
State :
TN
Country :
United States
Zip :
38016

Business Type

State incorporated in :
Public
Type of Legal Entity :
Association/Estate/Trust
Business Type :
Retail
Business Start Date :
-
EIN/Federal Tax ID Type :
Employer Identification Number
EIN/Federal Tax ID# :
Types of Goods Sold :

Ownership Information

Owner 1

Officer/Owners Name:
www
Title :
Social Security:
Home Address:
www
City :
ww
State:
ww
Country:
ww
Zip:
111
Drivers License:
wwww
Issue Date:
Jun, 18 2025
Expiration Date:
Jun, 17 2025
State:
wwww
DOB:
Jun, 17 2025
Home Phone Number:
% of Business Owned :
Length of Ownership :

Banking Information

Billing Type :
Gross Settlement
Name of Bank :
www
ABA Routing :
www
Account :
www

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 :
0%
Card Keyed In :
0% = 0%
Card Present :
0%
Card Not Present :
0% = 0%
Moto :
0%
Internet :
0%
Notes :

Terminal Answer

Batch Out Time :
Terminal Type :
www
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 :
Print Refund Policy On Footer :

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