PRE-APP COVER DETAILS

Created On Apr, 10 2024 09:42am   ID #7645 Back Download Add Merchant Resend Document for Sign

Attached Required Document Checklist :

-

Merchant (Business) DBA Name :

Williams Brothers

Business Legal Name :

Williams Brothers, Inc

Contact Name : Jane Crosswhite

Contact Phone Number : 6017509990

Physical Address :

10360 Road 375

City : Philadelphia

State : MS

Country : USA

Zip : 30350

Phone Number : 1234567890

Fax Number :

Email Address : williamsbros@bellsouth.net

Website :

Billing Address

Address :

10360 Road 375

City : Philadelphia

State : MS

Country : USA

Zip : 30350

Business Type

State incorporated in : Public

Type of Legal Entity : Sole Proprietor

Business Type : Lodging (Hotel/Motel)

Business Start Date : Apr, 26 2024

EIN/Federal Tax ID Type : Employer Identification Number

EIN/Federal Tax ID# : 456

Types of Goods Sold :

Ownership Information

Owner 1

Officer/Owners Name :

Abc

Title : Def

Social Security : 123

Home Address :

d

City : test city

State : Punjab

Country :

Zip : 101010

Drivers License : #123

Expiration Date : Jun, 30 2024

State : PB

DOB : May, 01 2023

Home Phone Number : 9696852365

% of Business Owned :

Length of Ownership :

Owner 2

Officer/Owners Name :

Demo

Title : Test

Social Security : 9633

Home Address :

d

City : city dummy

State : state dummy

Country : dummy

Zip : 631245

Drivers License : #456

Expiration Date : Dec, 31 2024

State : Punjab

DOB : Apr, 01 2022

Home Phone Number : 9988441133

% of Business Owned : 56

Length of Ownership :

Banking Information

Billing Type : Gross Settlement

Name of Bank : SBI

ABA Routing : 099663355

Account : 45454545

Estimated Sales Volume

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

$

Estimated Monthly Visa/MC/Discover/ AMEX Sales :

$

Average Ticket :

$

high Ticket :

$

Business Profile

Card Swiped :

0%

Card Keyed In :

0%

= 0%

Card Present :

0%

Card Not Present :

0%

= 0%

MOTO :

0%

Internet :

0%

Notes :

Terminal Answer

Batch Out Time : 11:00 AM

Terminal Type : Xyx Abc

Communication Method : Dial-phone

Do You Dial 9 For Outside Line? : No

Reprogram Terminal : No

Equipment Purchase : Yes

Equipment Rental Program : Yes

Next Day Funding : No

Tip Edit : Yes

EBT : No

FNS Number :

Tax Calculation : Yes

If So Tax Rate : 1.3

Refund Policy : 30 Days

Print Refund Policy On Footer : No

Software Or POS Integration Answer

POS Software Integration :

Software Name & Version :

MP/AP Name :

RP Name :

Pricing Provided :

Receipt Header Message :

Receipt Footer Message :

Front Drivers License Download

Front

Back Drivers License Download

Voided Check Download