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
		Pre App
		DL
		Bank Letter
		Business Tax License
		Signed App
		VAR Sheet

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

Calling about 2/20  transactions. they were combined with 2/21 transactions

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 Amjad Salem 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 20 2025			merchant called and wanted to know if he deposit has been sent for June 18th and 19th. Confirmed both days deposits have been sent and both should post today.
2	Mar 20 2024		Charlotte Groff	Amjad called about his deposits for Saturday, Sunday and Monday. Explained the issue to him and informed him that Saturday and Sunday deposits (3/16 & 3/17) were added together and sent Tuesday 3/19 and that Monday and Tuesday were added together and sent Wednesday.
3	Mar 05 2024		Charlotte Groff	requested merchant's rate to be returned back to 2.55% for Qual and 3.25% for Mid / Non Qual. It had been raised by 0.05%
4	Aug 01 2023			Amjad called inquiring why he doesn't have a deposit for 4/19 and we told him about SBC having so technical issues on that day and told him that it batched out on 4/21 and that his deposit will be in the bank after lunch today 4/24
5	Aug 01 2023		Mike Thomas	User: Mike Thomas -> Notes: Programmed S80 with EBT. Tricia will pick up today
6	Aug 01 2023		Morgan Withee	User: Morgan Withee -> Notes: The terminal did not have tap to pay enabled....had to walk tricia through correcting this and redownloading the terminal.
7	Aug 01 2023		Mike Thomas	User: Mike Thomas -> Notes: Downloaded PAX S80 and notified Tricia it was ready
8	Aug 01 2023			User: Charlotte Goff -> Notes: SBC - Simple Buxx ; Pax s80 for now; Merchant will be applying for EBT and when he gets his FNS # and we get him set up we'll swap the Pax out for a Valor; Batch Time 7:00 Central
9	Aug 01 2023		Morgan Withee	User: Morgan Withee -> Changed : TO Percent FROM 0 TO 2
10	Aug 01 2023		Morgan Withee	User: Morgan Withee -> Changed : Swipe Percent FROM 0 TO 98
11	Aug 01 2023		Morgan Withee	User: Morgan Withee -> Changed : MonthlyVolume FROM 0.00 TO 10000.00
12	Aug 01 2023		Morgan Withee	User: Morgan Withee -> Changed : AverageTicket FROM 0.00 TO 10.00
13	Apr 24 2023	Apr 24 2023	Jennifer Blanchard	Amjad called inquiring why he doesn't have a deposit for 4/19 and we told him about SBC having so technical issues on that day and told him that it batched out on 4/21 and that his deposit will be in the bank after lunch today 4/24
14	Oct 06 2022	Oct 06 2022	Kamal Oghad	User: Mike Thomas -> Notes: Programmed S80 with EBT. Tricia will pick up today
15	Oct 06 2022	Oct 06 2022	Kamal Oghad	User: Morgan Withee -> Notes: The terminal did not have tap to pay enabled....had to walk tricia through correcting this and redownloading the terminal.
16	Oct 06 2022	Oct 06 2022	Kamal Oghad	User: Mike Thomas -> Notes: Downloaded PAX S80 and notified Tricia it was ready

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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