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

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 HILTON GARDEN INN MEM/ST 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		Morgan Withee	User: Morgan Withee -> Notes: Sunita cell phone 901-212-4563
2	Aug 01 2023		Mike Thomas	User: Mike Thomas -> Notes: TT Larry advised him he is on Elavon gateway and emailed ([email protected]) his Vital number 2485366, BIN number 412942, and Nathan Wilcox ( Gateway Account Setup Coordinator, Gateway Boarding Elavon) contact info.
3	Aug 01 2023			User: Linda Billings from - Notes: Donna Smith called, April trans overchg of $10, tried to refund May 1, ran sale of $192.64, refunded, then ran again. Not seeing refund amt. Advised her to ck with her software support & see if VOID key works on register & use VOID when making adjustment on the same day, explain dif in refund & void & when to use. Virginia checking trans & will call Donna.
4	Aug 01 2023			User: Dianna - Department: x - Notes: Talked to Marty. A customer's card was charged twice.I called cs to confirm it. Told Marty and now going to refund customer.
5	Aug 01 2023			User: Raj Modhvadia - Department: 2 - Notes: Talked to Manoj today and he had a wonderful vacation to St. Louis. We conferenced American Express in and we believe he have fixed the problem. Manoj will keep an eye on the American Express activity to make sure all the money is going to the correct account, which it should be. I hope that everything is working now for them. Thanks
6	Aug 01 2023			User: Raj Modhvadia - Department: 2 - Notes: Talked to Manoj today and he was in St. Louis on vacation with his family. There is something wrong with his American Express. He called me let me say about 5 weeks ago with a new American Express number. I emailed it to Anita Bapat and got it updated. Manoj is telling me that he has not been receiving any American Express payments. Manoj told me that since he is in St. Louis on vacation with his family, that he will call me on Monday 11/5/2007 with the correct American Express number and we will conference in American Express to make sure that we are all on the same page. Thanks
7	Aug 01 2023		Mike Thomas	User: Mike Thomas - Department: 5 - Notes: TT Dee gave him merchant's rates.

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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