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
		EIN
		Voided Check
		Signed App
		VAR Sheet
		VAR Sheet2

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

SN - 118224735851

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 - 118221697929

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

Type

Install Date

Equipment ID

Status

Model

Purchase T.

PD Telephone

Sales Rep

Serial #

Tracking #

TID

Employee

Purchase Date

Already had the swiper on hand from last account

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

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 Rossville Nutrition House 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	Aug 01 2023			Downloaded Valor 100 Tricia will pick up
2	Aug 01 2023			Received confirmation from SBC that the monthly Statement fee has been updated to the $34.90
3	Aug 01 2023			Tricia called and wants us to send merchant a Valor100 for her store. She will also be keeping the Swipe Simple Mobile Reader for events. Per Tricia Emily approved $24.95/mo for the Valor and $9.95/mo for the Swipe Simple. Sent a request to SBC to have the monthly fee changed to $34.90
4	Aug 01 2023			TT Tricia reader ending in 3779 not pairing she will come by for another one
5	Aug 01 2023			Hasn't processed since 2/26/23 Tricia says they will know something by 3/16/23
6	Aug 01 2023			TT Dana, walked her through connecting Card reader....done
7	Aug 01 2023			User: Charlotte Goff -> Notes: Changed status to Approved
8	Aug 01 2023		Morgan Withee	User: Morgan Withee -> Changed : AverageTicket FROM 0.00 TO 12.00
9	Jul 21 2023		Mike Thomas	Tricia returned VL100 because it had the 3 blue lines on the main screen. I powered up the terminal and everything was normal. Deactivated terminal in Valor and put back into inventory. SN: 118221697929
10	Jun 05 2023	Jun 05 2023		Downloaded Valor 100 Tricia will pick up
11	Jun 05 2023	Jun 05 2023	Charlotte Groff	Received confirmation from SBC that the monthly Statement fee has been updated to the $34.90
12	Jun 05 2023	Jun 05 2023	Charlotte Groff	Tricia called and wants us to send merchant a Valor100 for her store. She will also be keeping the Swipe Simple Mobile Reader for events. Per Tricia Emily approved $24.95/mo for the Valor and $9.95/mo for the Swipe Simple. Sent a request to SBC to have the monthly fee changed to $34.90
13	May 31 2023	May 31 2023		TT Tricia reader ending in 3779 not pairing she will come by for another one
14	Mar 15 2023	Mar 15 2023		Hasn't processed since 2/26/23 Tricia says they will know something by 3/16/23
15	Feb 24 2023	Feb 24 2023		TT Dana, walked her through connecting Card reader....done

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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