ACH SERVICES MERCHANT AGREEMENTAch Services Merchant Agreement • June 2nd, 2015
Contract Type FiledJune 2nd, 2015COMPANY INFORMATION COMPANY NAME RESELLER NAME DBA RESELLER MID PHYSICAL ADDRESS CUSTOMER MID CITY STATE ZIP MAILING ADDRESS (IF DIFFERENT FROM ABOVE) CITY STATE ZIP PHONE FAX TAX ID NUMBER WEBSITE ADDRESS EMAIL ADDRESS YEARS IN BUSINESS YEARS UNDER CURRENT OWNERSHIP BUSINESS LOCATION TYPE STOREFRONT HOME WEB-BASED SPECIFY OTHER: BUSINESS TYPE LIMITED LIABILITY COMPANYPARTNERSHIP CORPORATION NON-PROFIT SOLE PROPRIETOR PUBLIC COMPANY INDUSTRY/PRODUCT AND/OR SERVICES SOLD PRIMARY BANK INFORMATION BANK NAME NAME ON ACCOUNT LOCATION ACCOUNT NUMBER ROUTING NUMBER BILLING ACCOUNT INFORMATION EMAIL ADDRESS (INVOICING) ACCOUNT NUMBER ROUTING NUMBER