ACH PROCESSING APPLICATION AND AGREEMENTAch Processing Agreement • December 18th, 2017
Contract Type FiledDecember 18th, 2017BUSINESS INFORMATION LEGAL BUSINESS OR CORPORATE NAME DOING BUSINESS AS NAME PHYSICAL ADDRESS CITY STATE ZIP BILLING ADDRESS CITY STATE ZIP BUSINESS WEBSITE URL BUSINESS PHONE BUSINESS FAX OTHER PHONE BUSINESS STRUCTURE (Check One)Sole Proprietor Partnership LLPC-Corporation S-Corp LLCNon-Profit Trust DATE FORMED YEARS IN BUSINESS # OF LOCATIONS FEDERAL TAX ID STATE TAX ID SALES TAX ID Other BUSINESS DESCRIPTION(BE SPECIFIC) TYPE OF BUSINESS MAIL ORDER % INBOUND PHONE % INTERNET % RETAIL % OUTBOUND PHONE % OTHER % INIDCATE SEC CODE: PPD/ CCD WEB TEL Please refer to Guidelines for SEC Codes to reference documents neededhttp://www.jetpay.com/resources/library/pdf/Guidelines_for_SEC_Codes.pdf CONTACT TITLE CONTACT EMAIL CONTACT PHONE