Common Contracts
1 similar Check Services Application/Service Agreement contracts
Check Services Application/Service Agreement • September 1st, 2011
REGISTERED DBA: (“YOUR STORE”) AND/OR: LEGAL NAME: FEDERAL TAX ID#: BUSINESS STREET ADDRESS: BUSINESS TELEPHONE: CITY: STATE: ZIP: EMAIL ADDRESS: BUSINESS OWNERSHIP TYPE: □ SOLE PROPRIETOR □ PARTNERSHIP □ CORPORATION DATE OF BIRTH: BUSINESS OWNER/GUARANTOR: (“CONSUMER/PRINCIPAL”) RESIDENTIAL STREET ADDRESS: PRINCIPAL’S TELEPHONE: CITY: STATE: ZIP: SSN OF PRINCIPAL: FAX NUMBER: PRINCIPAL’S DRIVER’S LICENSE#: CURRENT MONTHLY CHECK SALES: $ TOTAL MONTHLY CHECK LOSSES: $ AVERAGE CHECK SALE: $ AVERAGE RETURNED CHECK: $ PRODUCTS OR SERVICES OF APPLICANT: NUMBER OF LOCATIONS APPLIED FOR: CURRENT CHECK SERVICE: CURRENT RATE: POINT-OF-SALE EQUIPMENT TYPE: CHECK IMAGER/READER: PRINTER TYPE:
