Merchants

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Merchant ID

Legal Name

DBA Name

Processor

Agent

Split

Is Override

Password

Received Date

Approved Date

Activation Date

Closed Date

Product Type

Status

Address

Address 2

City

ZIP

Country

State

Contact

Email(comma separated)

Phone

Phone 2

Cell

Fax

URL

DBA Same as Legal Address

Address

City

ZIP

Country

State

Mailing Address Same as DBA

Address

City

ZIP

Country

State

File here *	Download	Notes *	Status	Date
		app
		app
		pre app
		app

Type

Install Date

Equipment ID

Status

Model

Purchase T.

PD Telephone

Sales Rep

Serial #

Tracking #

TID

Employee

Purchase Date

Type

Install Date

Equipment ID

Status

Model

Purchase T.

PD Telephone

Sales Rep

Serial #

Tracking #

TID

Employee

Purchase Date

Send Email to Merchant Send Email to Sales rep Send Email to Employee

Type

Install Date

Equipment ID

Status

Model

Purchase T.

PD Telephone

Sales Rep

Serial #

Tracking #

TID

Employee

Purchase Date

Send Email to Merchant Send Email to Sales rep Send Email to Employee

Bank 1 Information

Bank Name

Account Name

Rounting Number

Account Number

Billing Type

Gross Settlement

Net Settlement

Bank 2 Information

Bank Name

Account Name

Rounting Number

Account Number

Overrides who receive partial commission on all of Poplar Grove Utility District Accounts

Default Setup

Agent 1 Receives

%

on all Newly Inputted Accounts

Agent 2 Receives

%

on all Newly Inputted Accounts

Agent 3 Receives

%

on all Newly Inputted Accounts

Agent 4 Receives

%

on all Newly Inputted Accounts

Processor wise Setup

Select Processor *

Agent 1 Receives

%

on all Newly Inputted Accounts

Agent 2 Receives

%

on all Newly Inputted Accounts

Agent 3 Receives

%

on all Newly Inputted Accounts

Agent 4 Receives

%

on all Newly Inputted Accounts

Select Processor *

Agent 1 Receives

%

on all Newly Inputted Accounts

Agent 2 Receives

%

on all Newly Inputted Accounts

Agent 3 Receives

%

on all Newly Inputted Accounts

Agent 4 Receives

%

on all Newly Inputted Accounts

Merchant *

Month *

Year *

Merchant CMS

EIN/Federal Tax ID Type

MCC Code

EIN/Federal Tax ID #

Type of Legal Entity

State incorporated in

Types of Goods Sold

Primary Transaction Type

Internet

%

Swipe

%

Keyed

%

Average Ticket

Telephone Order

%

Annual Volume

Business Start Date

High Ticket

Persoanl Guarantor

Monthly Volume

Discount Method

Refund Policy

30 Days

60 Days

Other

None

Date

Reminder Date & Time

Employee

Notes

Sr. No.	Date	Reminder Date	Employee	Note	Action
1	Jan 31 2025		Charlotte Groff	Received a call from Carol stating that not all of the transactions that were processed through Auth.Net were settled from yesterday's transactions (1/30/25) . I exported the batch and emailed it to her.
2	Feb 06 2024		Charlotte Groff	Carol called asking about her batch for 2/2/24 transaction date (which should have batched 2/3). She said that she was only paid for part of the batch and that she received a settlement error batch report from Auth.net. I check IQ and saw that she was only paid for 59 transctions for $5449.55 on 2/3/24. She sent me her Auth.Net batch report that showed all the transactions and I went through each one to find the ones that had not batched. She had already called Auth.Net and had opened a ticket. Once I sent her the list of ones that had not batched, she presented that to Auth.Net and they are going to go ahead and send those in a batch.
3	Aug 01 2023			User: Charlotte Goff -> Notes: Carol called in about a chargeback for $267.76 where her customer is claiming that they cancelled the chargeback so that the duplicated payment from March could be a credit toward her future utility bill. The chargeback was debited from Poplar Grove's account on 4/15 but cardholder's bank is saying that Poplar Grove still holds the money. Conferenced Carol in with Mike from Vantiv Chargeback dept and he confirmed that she had been debited the funds and that they never received a notice that the chargeback had been cancelled.
4	Aug 01 2023			User: Charlotte Goff -> Notes: Carol called and had some questions about PCI.
5	Aug 01 2023			User: Emily Karawadra -> Notes: Morgan: Worked with Matthew from IVR in order to get their ivr system up and running. Tested out a few transactions until we got it working the way we needed to. Sent Carol an email asking her to approve the changes. Once changes are approved the change will take effect in 7 business days.
6	Aug 01 2023			User: Aimee Jones -> Changed : TO Percent FROM 0 TO 15
7	Aug 01 2023			User: Aimee Jones -> Changed : Internet Percent FROM 0 TO 85
8	Aug 01 2023			User: Aimee Jones -> Changed : AnnualVolume FROM 0 TO 1953000.00
9	Aug 01 2023			User: Aimee Jones -> Changed : AverageTicket FROM 0.00 TO 47.53

Application Type

Discount

Business Type

MCC Code

Visa/MC/Discover Rate Category

Base/Qualified (%)

Mid Qualified (%)

Non Qualified (%)

Base Debit- Non Pin Debit(Sig Debit Rate) (%)

Rewards Discount (%)

Statement Fee

Card On File Fee

PCI Fee

Non PCI Compliance

Authorization Fee

Per Item Fee

EBT Fee

FNS/EBT Number

Pin Debit Item Fee

Pin Debit Discount

Amex Opt Blue Rate

Base/Qualified Rate (%)

Mid Qualified Rate (%)

Non Qualified Rate (%)

Program Cost Opt Blue (%)

Authorization Fee

Per Item Fee

Other Monthly Fee

Ancillary Fees

Batch Fee

Retrievel Fee

Chargeback Fee

ACH Change Fee

Voice Auth Fee

Gateway Monthly Fee

Setup Fee

Owner 1 Information

Officer/Owners Name

Title

Social Security

Form of ID

ID #

Issue Date

Expiration Date

State

DOB

Home Phone Number

% of Business Owned

Length of Ownership

Y N

Home Address

Home city

Home state

Home country

Home zip

Owner 1 Information

Officer/Owners Name *

Title

Social Security

Form of ID *

ID # *

Issue Date *

Expiration Date *

State *

DOB *

Home Phone Number

% of Business Owned

Length of Ownership

Y N

Home Address *

Home city *

Home state *

Home country

Home zip *

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