This will provide a live merchant number. We will still need the faxed copy prior to transfer of funds to the merchants account if on conversion. Download instructions will be provided once accepted.
4 Digit sales office #
Business Name
Business Address
City State Zip
Phone
Fax
Owner name
Social Security
Merchant E-mail
Bank Name
Bank Address
Bank City, State Zip
Account Number Credits
|:
|:
Account Number Billing
|:
|:
What Sold
Average sale amount
Terminal type
Lipman 2085
Lipman 3000
Lipman 3020
Lipman 8000
Lipman 8320
Lipman 8400
Verifone Omni 3750
Verifone Omni 3740
Verifone Omni 3200
Verifone Tranz 460
Verifone Tranz 380
Verifone Tranz 330
Verifone Zon
Talento
IVI 3000
Ingenico Elite
Hypercom
Phone Auth
ARCNET
Internet
Check Reader type
None
Magtek RDR
CR 600
Welch Allen
CMR 431
EN 2500
RDM 6000 Imager
RDM 5000 Imager
Ingenico Imager
Magtek Imager
CR 1000 Imager
Service Requested
Conversion & Guarantee
Conversion & Verification
ARC
ARCNET
Verification
Guarantee
E-CHECK
PAYROLL
Rate
Transaction fee
Monthly fee
Monthly minimum
Install / App Fee
Notes
Password
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