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
		Signed app too large to upload
		Pre app too large to upload
		DL too large to upload

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

Batch Time 10:30pm - Tip at time of Sale     This terminal was returned can't read cards. Terminal is inactive

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

Batch time 10:30pm  - IP - Tip at Time of Sale SN: 118213111827

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

SN: 118221697940

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

SN: 141221904541

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

SN; 118234714367

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 Puerto Vallar 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	Jan 16 2025		Mike Thomas	TT Neil, changed one VL500 not to charge fee on signature debit. EPI 2501009274. Ran test, working as it should.
2	Sep 27 2024		Mike Thomas	Received text and email from Neil still asking about Valor Issue. I advised him again that Valor was down
3	Jul 29 2024		Mike Thomas	Advised Neil ,how to run a refund
4	Jul 01 2024		Mike Thomas	VL100 not reading chip cards. Sent replacement
5	Jun 28 2024		Alexander Wilkins	Spoke to Fermin at the location, informed him to go through the common fixes for connection issues. He unplugged his ethernet cable from the terminal and plugged it back in. Issue was resolved and terminal had connection issue resolved.
6	Aug 01 2023			Received Valor 100 back from merchant SN: 11821311817
7	Aug 01 2023			T Neil the merchant wanted SMS receipt and survey turned off. Turned both off and advised Neil how to update.
8	Aug 01 2023			TT Fermin he said he was having connection issues but everything is now working fine
9	Aug 01 2023		Mike Thomas	User: Mike Thomas -> Notes: Downloaded and shipped 2 Valor 100
10	Aug 01 2023			User: Charlotte Goff -> Notes: SBC - IBUXX - 3.95%; 2 Valor 100s - IP - Batch time 10:30pm - Tip at time of sale.
11	Aug 01 2023			User: Charlotte Goff -> Changed : TO Percent FROM 0 TO 3
12	Aug 01 2023			User: Charlotte Goff -> Changed : Swipe Percent FROM 0 TO 97
13	Aug 01 2023			User: Charlotte Goff -> Changed : MonthlyVolume FROM 0.00 TO 105000
14	Aug 01 2023			User: Charlotte Goff -> Changed : AnnualVolume FROM 0 TO 1395000.00
15	Aug 01 2023			User: Charlotte Goff -> Changed : AverageTicket FROM 0.00 TO 50.00

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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