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Merchant ID

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Address 2

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DBA Same as Legal Address

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Mailing Address Same as DBA

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File here *	Notes *	Status	Date
	DL
	voided check
	preapp
	signed app

Type

Install Date

Equipment ID

Status

Model

Purchase T.

PD Telephone

Sales Rep

Serial #

Tracking #

TID

Employee

Purchase Date

Invoice Number

Invoice Amount

Invoice Status

Send Email to Merchant Send Email to Sales rep Send Email to Employee

Type

Install Date

Equipment ID

Status

Model

Purchase T.

PD Telephone

Sales Rep

Serial #

Tracking #

TID

Employee

Purchase Date

Invoice Number

Invoice Amount

Invoice Status

Send Email to Merchant Send Email to Sales rep Send Email to Employee

Type

Install Date

Equipment ID

Status

Model

Purchase T.

PD Telephone

Sales Rep

Serial #

Tracking #

TID

Employee

Purchase Date

Send Email to Merchant Send Email to Sales rep Send Email to Employee

Type

Install Date

Equipment ID

Status

Model

Purchase T.

PD Telephone

Sales Rep

Serial #

Tracking #

TID

Employee

Purchase Date

Send Email to Merchant Send Email to Sales rep Send Email to Employee

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 Homer Skelton Ford Inc 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

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

Sr. No.	Date	Note	Created by	Updated at
1	Aug 01 2023 12:00 AM	Rodney wants to cancel this account because they don't process enough transactions to justify the cost of keeping it open. Canceled in NPCrm. Tricia is going to go pick up the equipment. Rodney will call Consignit and make sure they are aware that she's coming by to pick it up.	Dee Karawadra	Jan 31 2024 01:39 PM
2	Aug 01 2023 12:00 AM	Closing this location per Rodney's request. Location does not process cards often enough to warrant keeping the account. Submitted SR50741348 in NPCrm.	Dee Karawadra	Jan 31 2024 01:39 PM
3	Aug 01 2023 12:00 AM	Vantiv - Traditional - Dejavoo / Fluid Pay - Batch time 7:00pm - IP	Dee Karawadra	Jan 31 2024 01:39 PM

.....

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 *

Merchants

View Merchant

Bank 1 Information

Bank 2 Information

Overrides who receive partial commission on all of Homer Skelton Ford Inc Accounts

Default Setup

Merchant CMS

Owner 1 Information