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

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

***RETURNED***

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 Julian Apple Enterprise Inc 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	Oct 19 2023		Charlotte Groff	Submitted SR 58964904 to have Vantiv account closed.
2	Oct 19 2023			Received VX520 back from merchant as they are closing their account.
3	Oct 16 2023		Charlotte Groff	Sheila called in and wanted to update the mailing address to their home address. They are in the process of closing their business and have locked their business front doors and mail can not be delivered. Opened SR57410180 to have mailing address changed on Vantiv. Printed July - Sept statements and emailed them to her.
4	Oct 16 2023	Oct 16 2023	Mike Thomas	TT Sheila they are closing business so I advised her to send in a letter of cancellation to our support email.
5	Aug 01 2023			TT Merchant was wanting me to change to ethernet but she is still using dial it was changed to digital. We ran a test all is working
6	Aug 01 2023			Merchant called in and wanted to know if her terminal could be changed over from dial to internet. She has a vx520. I told her that once she got her internet set up to give us a call and get Tech support to change her terminal from dial to IP
7	Aug 01 2023		Morgan Withee	User: Morgan Withee -> Notes: Called in and said they got a call earlier this week from someone saying they needed to update their terminal. They did not think this was legit so they hung up and called us. I checked with everyone we did not call her to update her terminal. She is glad to know she hung up on that person. She did not need anything further.
8	Aug 01 2023		Mike Thomas	User: Mike Thomas -> Notes: TT William, wanted to know if terminal was programmed. Yes, he said he knew how to use and will set up today.
9	Aug 01 2023		Mike Thomas	User: Mike Thomas -> Notes: Downloaded and shipped VX520 dial. SN 803-235-882
10	Aug 01 2023		Morgan Withee	User: Morgan Withee -> Notes: Went over paperwork for conversion to Vantiv: Only additional fees he will be charged will be Semi Annual fee for $45, Pci Monthly Fee for $5.95, and Statement fee for $5, He said he will review the paperwork again now that he understands and should be sending it back shortly
11	Aug 01 2023			User: Pennye McAnulty -> Notes: Mailed paperwork to convert to Vantiv.
12	Aug 01 2023		Mike Thomas	User: Mike Thomas - Department: 5 - Notes: TT Bill, gave him settlement password (0000) and walked him through getting his report.

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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