Common Contracts

1 similar Check Services Application/Service Agreement contracts

CHECK SERVICES APPLICATION/SERVICE AGREEMENT
Check Services Application/Service Agreement • May 8th, 2014 • California

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:

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