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Merchant ID

Legal Name

DBA Name

Processor

Agent

Split

Is Override

Password

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Approved Date

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Address

Address 2

City

ZIP

Country

State

Contact

Email(comma separated)

Phone

Phone 2

Cell

Fax

URL

DBA Same as Legal Address

Address

City

ZIP

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State

Mailing Address Same as DBA

Address

City

ZIP

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File here *	Notes *	Status	Date
	DL- Boadie Anderson
	DL- John Anderson
	Application
	Pre app

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 TRADITION DRUG 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	Employee	Note	Created by	Updated at
1	Aug 01 2023 12:00 AM		User: Charlotte Goff -> Notes: emailed Johnna the PCS cancellation form and asked her to get Aaron to sign it and send it back to me.	Dee Karawadra	Jan 31 2024 01:39 PM
2	Aug 01 2023 12:00 AM		User: Charlotte Goff -> Notes: Changed status to Cancelled per email from Johnna Heilaman; uploaded email. Business was bought out.	Dee Karawadra	Jan 31 2024 01:39 PM
3	Aug 01 2023 12:00 AM	Mike Thomas	User: Mike Thomas -> Notes: TT Aaronall transactions are being declined. Conferenced all parties in ( merchant RISE and Computer RX) Computer RX is escalating the issue. Rise can't see anything hitting their system	Dee Karawadra	Jan 31 2024 01:39 PM

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No Owner Found!!

Merchants

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Bank 1 Information

Bank 2 Information

Overrides who receive partial commission on all of TRADITION DRUG Accounts

Default Setup

Merchant CMS