Created On Jun, 23 2025 07:13am ID #8093

Pre-app Cover Details

Attached Required Document Checklist :
-
Merchant (Business) DBA Name :
Test
Business Legal Name :
Test
Contact Name :
test
Contact Phone Number :
9685741236
Physical Address :
Malviya Nagar
City :
Bathinda
State :
Punjab
Country :
India
Zip :
151001
Phone Number :
Fax Number :
Email Address :
Website :

Billing Address

Address :
india
City :
india
State :
india
Country :
India
Zip :
380054

Business Type

State incorporated in :
Public
Type of Legal Entity :
Government
Business Type :
Restaurant
Business Start Date :
-
EIN/Federal Tax ID Type :
EIN/Federal Tax ID# :
Types of Goods Sold :

Ownership Information

Owner 1

Officer/Owners Name:
test
Title :
Mr.
Social Security:
0987654321
Home Address:
india
City :
india
State:
india
Country:
India
Zip:
380054
Drivers License:
987654321
Issue Date:
Jun, 02 2025
Expiration Date:
Jun, 14 2028
State:
india
DOB:
Feb, 05 1980
Home Phone Number:
01234567899
% of Business Owned :
Length of Ownership :

Banking Information

Billing Type :
Gross Settlement
Name of Bank :
Krishna Tiwari
ABA Routing :
098765432
Account :
098765432

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%
Ibuxx
Notes :

Terminal Answer

Batch Out Time :
Terminal Type :
131
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