MERCHANT MEMBER PACKAGE AGREEMENT & APPLICATION

Transcription

1 MERCHANT MEMBER PACKAGE AGREEMENT & APPLICATION Vantage Card Services, Inc Towne Lake Parkway Building 400, Suite 110 Woodstock, GA (800) (770) Fax (770) Vantage MID Company Info Business Legal Name Legal Address Merchant Location Info "Doing Business As" Name Location Address Legal Address 2 Location Address 2 City State Zip Contact Name Telephone Number Federal Tax ID Number Bus. Type (SCorp, LLC, Sole Prop,) City State Zip Location Contact Location Telephone Number Web Site Address Merchant Category Code Mail Statements and Chargebacks Legal DBA Other Location Fax Number Chargebacks Mail Fax Chargeback Fax Number Special Instructions Member Bank (Acquirer) Information Wells Fargo Bank, N.A P.O. Box 6079, Concord, CA (844) Important Member Bank (Acquirer) Responsibilities 1. The Bank is the only entity approved to extend acceptance of Card Organization products directly to a Merchant. 2. The Bank must be a principal (signer) to the Merchant Agreement. 3. The Bank is responsible for educating Merchants on pertinent Card Organization Rules with which Merchants must comply: but this information may be provided to you by Processor. 4. The Bank is responsible for and must provide settlement funds to the Merchant. 5. The Bank is responsible for all funds held in reserve. Merchant Resources Important Merchant Responsibilities 1. Ensure compliance with cardholder data security and storage requirements. 2. Maintain fraud and chargebacks below Card Organization thresholds. 3. Review and understand the terms of the Merchant Agreement. 4. Comply with Card Organization Rules. 5. Retain a signed copy of this Disclosure Page. You may download Visa Regulations from Visa s website at: You may download MasterCard Rules from MasterCard s website at: You may download additional merchant information from Discover s website at: You may download American Express Merchant Operating Requirements at MerchantPolicyOptBlue.pdf The responsibilities above do not replace the terms of the Merchant Agreement and are provided to ensure the Merchant understands some important obligations of each party and that the Bank is the ultimate authority should the Merchant experience any problems. v VCS-WF p.1

2 Signer Info (Individual with Control a single individual with significant responsibility for managing the merchant who has authority to sign for the business) Owner / Officer Name Social Security Number Home Address City Zip Title % of Ownership Home Phone State Address Politically Exposed Persons require more due diligence under anti-corruption and anti-money laundering compliance: Is any owner, officer, director, employee, or agent a current or former senior official in the executive, legislative, administrative, military, or judicial branch of any government (elected or not); a senior official of a major political party; an executive of a government-owned commercial enterprise; a family member of any of the foregoing officials; or a close personal or professional associate of any of the foregoing officials? If yes please attach details. Yes No Beneficial Owners (Please list each individual who owns 25% or more of the equity interests) % Ownership Name Home Address SSN DOB Personal Guaranty I/We hereby irrevocably guarantee to Global Direct and Member, their successors and assigns, the full, prompt, and complete performance of Merchant and all of Merchant's obligations under the Card Services Agreement, including but not limited to all monetary obligations arising out of Merchant's performance or non-performance under the Card Services Agreement, whether arising before or after termination of the Card Services Agreement. This guaranty shall not be discharged or otherwise affected by any waiver, indulgence, compromise, settlement, extension of credit, or variation of terms of the Card Services Agreement made by or agreed to by Global Direct, Member and/or Merchant. I/We hereby waive any notice of acceptance of this guaranty, notice of non-payment or nonperformance of any provision of the Card Services Agreement by Merchant, and all other notices or demands regarding the Card Services Agreement. I/We agree to promptly provide to Global Direct and Member any information requested by any of them from time to time concerning my/our financial condition(s), business history, business relationships, and employment information. I/We agree that Global Direct and Global Direct (on behalf of Member) may order a consumer credit report on me, Merchant and each of Merchant s officers, partners, and/or owners, as well as subsequent consumer credit reports, which may be required or used in conjunction with the maintenance, updating, renewal or extension of the services provided hereunder, or in conjunction with reviewing, taking collection action on, or other legitimate purposes associated with the Merchant account. I/We have read, understand, and agree to be bound by the Card Services Terms & Conditions provided to Merchant and those terms and conditions contained in this Merchant Application. An individual An individual Signature of Guarantor Signature of Guarantor Proposal ID Site ID merchantrates.com v VCS-WF p.2

3 Vantage MID Rate & Fee Disclosure Primarily Card Type Rate Auth / Item Other Fees Card Present Visa Credit Annual Membership Card Not Present Visa Debit Monthly Statement Check all that apply MasterCard Credit Minimum Monthly Retail MasterCard Debit Voice Authorization Restaurant / QSR Discover Credit AVS Authorization Level 3 Discover Debit Chargeback / NSF ecommerce PayPal Credit Card Present Touch Tone Auth MOTO EBT Bank Admin Fee Wireless / Mobile PIN Debit FANF Fee China Union Pay PCI DSS Fee Compliance American Express PCI DSS Non-Compliance 0.15% $0.100 $9.95 Assoc # Existing AmEx # Regulatory Compliance Chain # 0.15% $0.100 $ % $0.100 $ % $0.100 $20.00 $0.00 $3.82 $5.95 Pass-Through Interchange, Dues, Assessments, Access, Acquirer, License Fees Transactions that do not qualify for the most favorable interchange rates will be subject to increased interchange rates. See section 33 the Card Services Terms and Conditions for more information regarding the circumstances in which increased interchange rates may apply. Discount rates and other percentage fees are calculated by multiplying the rates or fees and the Merchant s applicable transaction volume. Per item and per authorization fees are calculated per transaction or authorization, as applicable. In addition to the per item fee, all Debit transactions include fees assessed by the applicable network organization. $1.95 Merchant Trade References Trade Reference 1 Contact Name Telephone Trade Reference 2 Contact Name Telephone Tell us about your business Goods/Services Sold Future Delivery Annual Bankcard Sales $3,500, $7, # of locations Seasonal Sales Average Transaction $ Business Est. Date Current Owner Date % of Non-Swipe Sales Premises Inspection Building Type Office Shopping Stand Alone Residence Other Premises is Own Lease Landlord Name Landlord Phone Square Footage >2000 Neighboring Businesses Risk Review Status Business signage visible? Yes No Business currently operating? Yes No Have you previously accepted card payments? Yes No Merchant name consistent with signage? Yes No Are you currently accepting card payments? Yes No Applicable inventory present? Yes No Ever declared business or personal bankruptcy? Yes No Does the merchant use fulfillment house? Yes No Ever been terminated from accepting card payments? Yes No If no, was the fulfillment house inspected? Yes No Card numbers accepted electronically over the Internet? Yes No Are card acceptance decals visible? Yes No AmEx annual volume < $1,000,000 Yes No AmEx Acceptance Yes No AmEx Marketing Yes No 0 Christina Rice Vantage Agent Agent ID Referral Source v VCS-WF p.3 Merchant Initials

4 ACCEPTANCE OF TERMS & CONDITIONS / MERCHANT AUTHORIZATION Your Card Services Agreement is between Global Payments Direct, Inc. ("Global Direct"), the Merchant named above, and the Member named below ("Member"). Member is a member of Visa, USA, Inc. ("Visa") and MasterCard International, Inc. ("MasterCard"); Global Direct is a registered independent sales organization of Visa, a member service provider of MasterCard and a registered acquirer for Discover Financial Services, LLC. ("Discover") and a registered Program Participant of American Express Travel Related Services Company, Inc. ( American Express ). A copy of the Card Services Terms and Conditions, revision number VCS-WF, has been provided to you. Please sign below to signify that you have received a copy of the Card Services Terms & Conditions and that you agree to all terms and conditions contained therein. If this Merchant Application is accepted for card services, Merchant agrees to comply with the Merchant Application and the Card Services Terms & Conditions as may be modified or amended in the future. If you disagree with any Card Services Terms & Conditions, do not accept service. IF MERCHANT SUBMITS A TRANSACTION TO GLOBAL DIRECT HEREUNDER, MERCHANT WILL BE DEEMED TO HAVE ACCEPTED THE CARD SERVICES TERMS & CONDITIONS. Application must be signed by Owner if Sole Proprietorship or; Partners/Officers with greater than 50% combined Ownership if Partnership or Corporation. By your signature below on behalf of Merchant, you certify that all information provided in this Merchant Application is true and accurate and you authorize Global Direct, and Global Direct on Member's behalf, to initiate debit entries to Merchant's checking account(s) in accordance with the Card Services Terms and Conditions. In addition by adding your signature below on behalf of Merchant you authorize Global Direct and/or Vantage Card Services, Inc. to order a consumer credit report on you, Merchant and each of Merchant s officers, partners, and/or owners, as well as subsequent consumer credit reports, which may be required or used in conjunction with the maintenance, updating, renewal or extension of the services provided hereunder, or in conjunction with reviewing, taking collection action on, or other legitimate purposes associated with the Merchant Account. x Signing for Global Payments Direct, Inc. Name (print) Title Date x Signing for Member Name (print) Wells Fargo Bank Date Direct ACH Credits & Debits Authorization Agreement I hereby authorize Vantage Card Services, Inc. to initiate credit and debit entries to my checking account indicated below at the depository financial institution named below. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. This authorization is to remain in full force and effect until Vantage Card Services, Inc. has received written notification of termination in such time and in such manner as to afford Vantage Card Services, Inc. and Bank a reasonable opportunity to act on it. Note: All written credit and debit authorizations must provide that the receiver may revoke the authorization only by notifying the originator in the manner specified in the authorization. Bank Info Bank Name Include copy of a Voided Check or Bank Letter Include copy of Current Merchant Statement Bank Contact Include copy of your Business License Bank Phone Bank Account Type Bank Routing # For Office Use Bank Account # Signature Date Billing disputes must be forwarded, in writing, to Customer Service within 60 days of the date of the statement and/or notice. v VCS-WF p.4

5 Please visit for more on PCI related services. Cardholder Data Storage Compliance & Service Provider PCI DSS and Card Network rules prohibit storage of sensitive authentication data after the transaction has been authorized (even if encrypted). If you or your POS system store, process, or transmit full cardholder s data, then you (merchant) must validate PCI DSS compliance. If you (merchant) utilize a payment application the POS software must be PA DSS (Payment Application Data Security Standards) validated where applicable. If you use a payment gateway, they must be PCI DSS Compliant. As required under the Payment Card Industry Data Security Standard (PCI DSS), I do hereby declare and confirm the following: Questions: Merchant will maintain full PCI DSS compliance at all times and will notify Global Payments when it changes its point of sale software, system, application or vendor Do your transactions process through any other Third Parties (i.e. web hosting companies, gateways, corporate office)? Merchant utilizes the services of a PCI SSC Qualified Integrator Reseller (QIR) when POS payment applications are utilized. The signing merchant listed below has experienced an account data compromise.* The signing merchant listed below is storing Sensitive Authentication Data** (even if encrypted) after the transaction has been authorized. (I have never accepted payment cards.) (I have never accepted payment cards.) Merchant utilizes an EMV enabled terminal *An Account Data Compromise is any incident that results in unauthorized access to payment card data and/or Sensitive Authentication Data. **Sensitive Authentication Data is security related information (Card Verification Values, complete Magnetic Stripe Data, PINs, and PIN blocks) that is used to authenticate cardholders. Please note that if you have indicated that your organization has experienced an account data compromise in the past, a PCI DSS Level 1 Compliance Assessment may be required upon Global s request. A compromise of cardholder data from your location(s) may result in the issuance of fines and/or penalties by the card brand, for which you will be responsible under your Merchant Agreement, notwithstanding this Compliance Statement. It is imperative that you notify Global Payments immediately should the information on this Compliance Statement change. v VCS-WF p.5 Merchant Initials

6 Terminal Network Services Network Global Terminal Capture Global Host Capture Vital POS System Contact Phone # Version # Communication Dial IP VPN Terminal Type Quantity Price Total Terms Buy Rent Own Total Due Three Pay Purchase Note: All Purchases carry a one year warranty. Merchant expressly acknowledges that ALL rental or loaned equipment is and shall remain the property of Vantage Card Services, Inc. and any rental or loaned equipment not returned upon request and any damaged rental or loaned equipment returned will be billed at a maximum of $500/per unit replacement price. The business checking account attached for card processing will be ACH debited for supply orders and equipment fees due. Programming Options Set Up Programming Notes Retail Server # All Sales Final Restaurant Invoice # Auto Close Time: AVS Signature Capture $9.95/mo CVV2 Terminal Communication Method WiFi (Secure wireless router WAP2 configuration separate from any public use) IP (Ethernet cable from your router to your sales counter not provided) Dial (Dial service must be from an analog line (not digital or VoIP) and add $0.01/per Authorization if primary comm method) PAB Dial Number (ex. Dial a 9 to get an outside line) Additional Services Type Activation Mo. Access Per Item Notes Internet Gateway Level 3 Gateway * Please note Gateway Set Up by location as: Retail/Swipe Virtual Terminal Only ecommerce/vt GPRS SIM Tax Amount Check Services See separate application v VCS-WF p.6