Merchant Services Application and AgreementMerchant Services Application and Agreement • April 8th, 2011 • Texas
Contract Type FiledApril 8th, 2011 JurisdictionProducts Requested (Check All That Apply) Virtual Terminal Transporter Secure Webpay Soft Terminal✔ Direct Interface / API Direct Billing Other – Specify Estimated Monthly ACH / e-Check and Credit Card Volume Will You Be Using ACH To Collect Funds? Yes No If Yes, Complete Below. Will You Be Using Credit Cards To Collect Funds or Yes NoAccept Online Rental Apps? If Yes, Complete Below. Average Sale$ Maximum Sale$ Monthly Sales$ Average Sale$ Maximum Sale$ Monthly Sale$ Please Specify The Products / Services That You Will Be Collecting for via ACH. Please Specify The Products / Services That You Will Be Collecting for viaCredit Cards. Will You Be Using ACH To Disburse Funds?If Yes, Complete Below. Yes No Transaction TypesHow Will You Be Obtaining Authorization For Your Transactions?(Please Indicate By Filling In The Percentages.) % Face-to-face (PPD / CCD / BOC / POP) % Single % Internet Order (WEB) % Recurring % Mail Order (ARC) 100 % Total % Telephone Order (TEL) % Fax (PPD / CCD) 100