PRE-APP COVER DETAILS
Attached Required Document Checklist :
-Merchant (Business) DBA Name :
Emily KarawadraBusiness Legal Name :
testContact Name : Emily Karawadra
Contact Phone Number : 9015170002
Physical Address :
10080 TN-194City : Oakland
State : TN
Country : United States
Zip : 38060
Phone Number :
Fax Number :
Email Address : connect.jaswinder@gmail.com
Website :
Billing Address
Address :
10080 TN-194City : Oakland
State : TN
Country : United States
Zip : 38060
Business Type
State incorporated in : Public
Type of Legal Entity : Non-Profit/ Tax Exempt 501C
Business Type : Mail/Telephone Order
Business Start Date : Dec, 29 2019
EIN/Federal Tax ID Type : Employer Identification Number
EIN/Federal Tax ID# :
Types of Goods Sold : Services, xyz
Ownership Information
Owner 1
Officer/Owners Name :
Mr John SmithTitle : Owner
Social Security : TYU5656
Home Address :
#2971, Malviya NagarCity : Bathinda
State : Punjab
Country : India
Zip : 151001
Drivers License : 7678GH5656
Expiration Date : Dec, 31 2025
State : PB
DOB : Aug, 23 2000
Home Phone Number : 89568456456
% of Business Owned : 95
Length of Ownership : 5 Years
Owner 2
Officer/Owners Name :
Ms Lisa TylorTitle : Director
Social Security : BHV565GFD
Home Address :
Z01117, Ganesha BastiCity : Sirsa
State : Haryana
Country :
Zip : 561223
Drivers License : #6788GHFR7
Expiration Date : Mar, 31 2025
State : HR
DOB : Nov, 10 1992
Home Phone Number : 8797465456
% of Business Owned : 5
Length of Ownership : 2 years
Banking Information
Billing Type : Gross Settlement
Name of Bank : State Bank of India
ABA Routing : 026009140
Account : 56785422434678866
Estimated Sales Volume
Estimated Annual Sales Visa/MC/Discover/ AMEX Sales :
$23000Estimated Monthly Visa/MC/Discover/ AMEX Sales :
$89555Average Ticket :
$12345high Ticket :
$56789Business Profile
Card Swiped :
100%Card Keyed In :
0%= 100%
Card Present :
90%Card Not Present :
10%= 100%
MOTO :
60%Internet :
40%
Notes :
Terminal Answer
Batch Out Time : 11:00 AM
Terminal Type : ytytyu
Communication Method : Dial-phone
Do You Dial 9 For Outside Line? : No
Reprogram Terminal : No
Equipment Purchase : No
Equipment Rental Program : Yes
Next Day Funding : Yes
Tip Edit : No
EBT : No
FNS Number :
Tax Calculation : No
If So Tax Rate :
Refund Policy : 30 Days
Print Refund Policy On Footer : No
Software Or POS Integration Answer
POS Software Integration : No
Software Name & Version : Test
MP/AP Name : Patricia
RP Name : Patricia
Pricing Provided : Statement Analysis
Receipt Header Message :
Receipt Footer Message :
Front Drivers License Download
Back Drivers License Download
Voided Check Download
Business Document 1 Download
