Attached Required Document Checklist :
-Merchant (Business) DBA Name :
Test of Link SubmissionBusiness Legal Name :
Testing CRM LLCContact Name : Charlotte Groff
Contact Phone Number : 9016010032
Physical Address :
1164 Vickery Lane, Cordova, TN, USACity : Cordova
State : TN
Country : USA
Zip : 38016
Phone Number : 9016010032
Fax Number :
Email Address : charlotte@impactpays.com
Website :
Address :
1164 Vickery Lane, Cordova, TN, USACity : Cordova
State : TN
Country : USA
Zip : 38016
State incorporated in : Public
Type of Legal Entity : LLC
Business Type : Retail
Business Start Date : Jan, 01 2000
EIN/Federal Tax ID Type : Employer Identification Number
EIN/Federal Tax ID# : 99-1234567
Types of Goods Sold : Credit card processing
Officer/Owners Name :
Dee karawadraTitle : CEO
Social Security : 123-45-6789
Home Address :
1234 Testing StCity : Collierville
State : TN
Country :
Zip : 38017
Drivers License : 00123987
Expiration Date : Jun, 01 2026
State : TN
DOB : Jun, 01 1965
Home Phone Number : 901-517-0002
% of Business Owned : 100
Length of Ownership : 24 years
Billing Type : Gross Settlement
Name of Bank : Regions
ABA Routing : 064000017
Account : 0011111111
Estimated Annual Sales Visa/MC/Discover/ AMEX Sales :
$1200000Estimated Monthly Visa/MC/Discover/ AMEX Sales :
$200000Average Ticket :
$500high Ticket :
$10000Card Swiped :
0%Card Keyed In :
100%= 100%
Card Present :
0%Card Not Present :
100%= 100%
MOTO :
100%Internet :
0%Traditional
Notes :
Batch Out Time : 11:00 AM
Terminal Type : Dejavoo
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 : Yes
Tip Edit : No
EBT : No
FNS Number :
Tax Calculation : No
If So Tax Rate :
Refund Policy : None
Print Refund Policy On Footer : No
POS Software Integration :
Software Name & Version :
MP/AP Name : Charlotte Groff
RP Name :
Pricing Provided :
Receipt Header Message :
Receipt Footer Message :