Local Card Guy - Merchant Pre-App

Agent Pre-App

DBA Name

Sales Agent

Boarding

Business Type

If CardPointe:

ISO Side

Agent Side

Type of Pricing

Basis Points

Transaction Fee

Pin Debit

Yes

Percentage for Cash Discounting if Applicable

Type of Equipment

IF CLOVER RESTAURANT UPLOAD MENU

Who is Paying for Equipment

Ship Equipment to:

Type of Connection

Ethernet

Wi-Fi

Neither/VT or Mobile

Approximate Go-Live Date

When to send MPA?

Fees: Specify if you want to charge a specific price for a fee, otherwise standard fees will be applied

Any other info we need to know:

Agents: All fields must be completed. If fields are missing data, the agreement will not be created nor will we reach-out to request. Thank you