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
		var
		pre app
		signed app
		ein
		DL
		bank letter

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

WiFi - IBUXX - 3.95%;  Batch Time 7:00pm - Tip at time of Sale

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 Choctaw Nutrition 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	Jun 02 2025		Charlotte Groff	Jamie asked if I could send her the store's tax reports for 2022, 2023 & 2024. I pulled those from Swipe Simple and emailed them over to her.
2	Apr 25 2025		Alexander Wilkins	Reactivated both Swipesimple and SBC account. Informed David that the merchant can start using their account again and to let us know once they have fully moved so we can turn them back off.
3	Apr 25 2025		Alexander Wilkins	Got a call from David requesting to reactivate the SBC and SwipeSimple accounts as the merchant is moving. Merchant needed a Dongle to be able to take payments while the Skytab equipment is being moved. Requesting both accounts to be reactivated.
4	Jan 28 2025		Charlotte Groff	Received signed cancellation request from Jamie and submitted it to SBC for closing out her account. Canceled in our system too.
5	Jan 22 2025		Charlotte Groff	Sent SBC Cancellation request form to Jamie to sign so we can get the SBC account closed out.
6	Jan 22 2025		Mike Thomas	Cancelled Swipe Simple
7	Aug 01 2023		Morgan Withee	User: Morgan Withee -> Notes: SS Password: Choctaw22
8	Aug 01 2023		Mike Thomas	User: Mike Thomas -> Notes: Customer says she shows transactions on her bank report for 3 trans actions which the merchant can't fine. We can't find them either merchants thinks it's a banking issue
9	Aug 01 2023		Kamal Oghad	User: Kamal Oghad -> Notes: moved to SwipeSimple
10	Aug 01 2023			User: Charlotte Goff -> Notes: David called with Jamie on the phone and she had run a transaction for a refund instead of a sale. I walked her through how to void the transaction.
11	Aug 01 2023		Mike Thomas	User: Mike Thomas -> Notes: Downloaded And notified David that terminal is ready
12	Aug 01 2023			User: Charlotte Goff -> Notes: SBC - IBUXX - $0.59 Valor100 - WiFi - Batch time 7:00pm - Tip at time of sale
13	Aug 01 2023			User: Charlotte Goff -> Changed : TO Percent FROM 0 TO 2
14	Aug 01 2023			User: Charlotte Goff -> Changed : Swipe Percent FROM 0 TO 98
15	Aug 01 2023			User: Charlotte Goff -> Changed : MonthlyVolume FROM 0.00 TO 10000
16	Aug 01 2023			User: Charlotte Goff -> Changed : AverageTicket FROM 0.00 TO 10.00

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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