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Merchant ID

Legal Name

DBA Name

Processor

Agent

Split

Is Override

Password

Status

Received Date

Approved Date

Activation Date

Closed Date

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

Country

State

Mailing Address Same as DBA

Address

City

ZIP

Country

State

File here *	Notes *	Status	Date
	Pre App will not upload due to size
	voided check will not upload due to size
	DL will no upload due to size
	signed application

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

Has 4 B250 Dongles

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 Mid South Fun Box 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	Reminder Date	Employee	Note	Created by	Updated at
1	Oct 19 2023 12:00 AM	Oct 19 2023	Mike Thomas	TT David and Stu (Stl. Hilton) emailed return label (tracking number 773798678842) Email: stu.hanson@stlhilton.com. Stu will call me when he receives the email. He is sending back four B200 card readers.	Dee Karawadra	Jan 31 2024 01:39 PM
2	Sep 07 2023 12:00 AM	Sep 07 2023	Mike Thomas	Have tried to call merchant 3 times to see what the status is, keep getting voicemail and leaving messages	Dee Karawadra	Jan 31 2024 01:39 PM
3	Aug 30 2023 12:00 AM	Aug 30 2023	Mike Thomas	Set up Swipe Simple	Dee Karawadra	Jan 31 2024 01:39 PM
4	Aug 30 2023 12:00 AM		Charlotte Groff	SBC - traditional - Swipe Simple Mobile with 4 dongles - Batch time 8:00pm - SEASONAL Business with open season running March 1 through November (Black Friday)	Dee Karawadra	Jan 31 2024 01:39 PM

.....

No Owner Found!!

Merchants

View Merchant

Bank 1 Information

Bank 2 Information

Overrides who receive partial commission on all of Mid South Fun Box Accounts

Default Setup

Merchant CMS