PRE-APP COVER DETAILS

Created On Mar, 20 2024 14:58pm   ID #7612 Back Download Add Merchant Resend Document for Sign

Attached Required Document Checklist :

-

Merchant (Business) DBA Name :

Test 101

Business Legal Name :

Test 101

Contact Name : Jack Black

Contact Phone Number : 9016010032

Physical Address :

123 ABC Rd

City : Cordova

State : tn

Country : us

Zip : 38016

Phone Number :

Fax Number :

Email Address : support@impactpays.com

Website :

Billing Address

Address :

123 ABC Rd

City : Cordova

State : tn

Country : us

Zip : 38016

Business Type

State incorporated in : Public

Type of Legal Entity : Sole Proprietor

Business Type : Retail

Business Start Date : Jan, 01 2015

EIN/Federal Tax ID Type : Social Security Number

EIN/Federal Tax ID# : 007116555

Types of Goods Sold : retail

Ownership Information

Owner 1

Officer/Owners Name :

Jack Black

Title : Owner

Social Security : 007116555

Home Address :

1164 Vickery Lane 200

City : Cordova

State : Tennessee

Country : United States

Zip : 38016

Drivers License : 1236544

Expiration Date : Jan, 01 2025

State : TN

DOB : Jan, 12 1976

Home Phone Number : 9016924540

% of Business Owned : 100

Length of Ownership :

Banking Information

Billing Type : Gross Settlement

Name of Bank : Jack Black

ABA Routing : 084000026

Account : 100102522

Estimated Sales Volume

Estimated Annual Sales Visa/MC/Discover/ AMEX Sales :

$150000

Estimated Monthly Visa/MC/Discover/ AMEX Sales :

$10000

Average Ticket :

$150

high Ticket :

$1000

Business Profile

Card Swiped :

100%

Card Keyed In :

0%

= 100%

Card Present :

100%

Card Not Present :

0%

= 100%

MOTO :

0%

Internet :

0%

IBUXX

Notes :

Terminal Answer

Batch Out Time : 11:00 AM

Terminal Type : valor

Communication Method : IP-internet

Do You Dial 9 For Outside Line? : Yes

Reprogram Terminal : No

Equipment Purchase : No

Equipment Rental Program : Yes

Next Day Funding :

Tip Edit : Yes

EBT : Yes

FNS Number : 0000000

Tax Calculation : Yes

If So Tax Rate : 0

Refund Policy : 30 Days

Print Refund Policy On Footer : No

Software Or POS Integration Answer

POS Software Integration : No

Software Name & Version :

MP/AP Name :

RP Name : 2097

Pricing Provided :

Receipt Header Message :

Receipt Footer Message :

Front Drivers License Download

Back Drivers License Download

Voided Check Download

Business Document 1 Download

Business Document 2 Download

Business Document 3 Download