Common Contracts

Contract

Service Application and Agreement • May 24th, 2017 • New York

• Contract Type
  Service Application and Agreement
• Filed
  May 24th, 2017
• Jurisdiction
  New York

TELECHECK SERVICE APPLICATION and AGREEMENT‌‌ VISA/MC MID# Location of Area Group# Parent ID# TCK BT# TCK Loc # DataEntry Only SIC Code Description Assoc. Code Assoc. Name (1) MERCHANTS INVOICING (BILL-TO) INFORMATION Legal Company Name Your DBA Name (if applicable) Store # Address Suite # City State Zip Code First/Last Contact Name Contact Title Business Phone # Contact Email Address Business Fax # Special Instructions (2) MERCHANT LOCATION INFORMATION ADDRESS SAME AS INVOICING (BILL-TO) Legal Company Name Your DBA Name (if applicable) STORE # Address (No P.O. Box) Suite # City State Zip Code Contact Name Contact Title Contact Email Address Phone # Fax # Website (required for Online) WWW (3) BUSINESS AND OWNERSHIP INFORMATION Business/Product lines for last 2 years Annual Revenues Name (as it appears on your income tax return) State/Federal TAX ID (as it appears on your income tax return) State Incorp. Started (MM/YYYY) # of Employees Dun & BradStreet ID Yes No Is a publicly tr