Universal APPLICATION FOR MERCHANT CARD PROCESSING ISO/ISA

Universal APPLICATION FOR MERCHANT CARD PROCESSING ISO/ISA An application must be completed for each merchant that is applying for bankcard processing. If an applicant has more than one business, using different legal names, an application must be completed for each. 1. STW Short Name The STW Short Name identifies the ISO/ISA associated with the merchant application. 2. Assoc # - The association number is used to identify the pricing structure used for the merchant. 3. Division # - Do not use, N/A 4. Sales Rep Name Sales representative responsible for the application. 5. Sales Rep Code This is a four digit code identifying the sales representative submitting the application. 6. Branch # - Do not use, N/A BUSINESS INFORMATION 7. Legal Business Name - Legal name of the business. The name cannot be longer than 23 characters. (required) a. Legal Address - The legal address of the business. This may be a P.O. Box. b. City - The city of the legal address. c. State - The state of the legal address. d. Zip - The legal address zip code. e. Legal Phone Number This is the legal phone number. (required) f. Legal Fax Number Legal fax number. This may be used to send chargeback notifications to the merchant. (optional) 8. DBA Name - The DBA name of the business is the name that the company is Doing Business As. This may be the same as the legal name, in which case it is not necessary to complete the DBA information. Writing SAME as Legal is acceptable. A legal entity may have multiple businesses with separate DBA names. The name cannot be longer than 23 characters. DBA name is required if different than Legal Business Name. a. DBA Address This is the street/physical address for DBA location. We must have a street address on all merchants. If the Legal address is a P.O. Box, a secondary address or mailing address only, this field is required. b. City The city of the DBA location c. State - The DBA s state d. Zip - The zip code of the DBA location. e. DBA/Customer Service Phone Number If the DBA phone number is different than the legal phone number this field is required. f. DBA Fax number The fax number of the DBA location. 9. Email Address for Notices Merchant s email address. This is currently used for sending the welcome message for Transaction Central merchants only. (required for Transaction Central merchants) Dir V1. 1008

10. Web Site Address Merchant s web site address. The credit department will review the web site when verifying business information. This is only required for ecommerce merchants. 11. Preferred Address for: a. Statements? Should statements be mailed to the Legal or DBA address? b. Chargebacks? Should chargeback notices be mailed to the Legal or DBA address OR should they be faxed to a dedicated fax number? c. Provide the name of the contact to whom the notices will be faxed or mailed. 12. Federal Tax ID # - This is the merchant s Federal Tax ID or Employer ID Number (EIN). This is a 9 digit number. If the business is a sole proprietorship, they may use their social security number. 13. Length Owned - The years and months that the business has been open under the current ownership. If this is a newly opened business, or is under new ownership, enter 0. 14. Any Prior Bankruptcies - If any of the owner(s) or the business has had a previous bankruptcy, indicate if it was either personal or business and the filing date. A Bankruptcy does not automatically decline the application. 15. Type of Ownership a. Sole Proprietorship, Date of Birth List owner s date of birth if the merchant is a sole proprietorship. b. Mark the appropriate ownership type if other than sole proprietorship. This is very important for credit to understand the type of entity that TF is contracting. Each type has a different group of responsible parties. 16. Type of Business a. Indicate if the business is retail, restaurant, lodging, service. If the business is a MOTO business, mark retail. b. Business to business percentage this would possibly indicate a wholesale operation with little to no consumer business, c. Internet percentage This would indicate the percentage of ecommerce business. d. Mail order/telephone order percentage This would indicate the percentage of card not present transactions e. Detailed Business Description - Enter information that gives a description of the business, the products and/or services sold f. The MCC or SIC code is for internal use only. TransFirst will assign the code during the application check-in process. OWNER AND OR OFFICER INFORMATION 17. Owner and or Officer Information - Please reflect at least 50% ownership in this section. - Name of principal, title, % of ownership, Social Security Number (SSN), RESIDENTIAL address and phone are required. - If there is no ownership then Corp resolution and articles of Incorporation are required. For non profit an IRS 501(C)(3) letter is required. Any authorized officer may sign the application. Dir V1. 1008 2

PROCESSING INFORMATION 18. Have you ever accepted credit cards before? Mark yes or no. If yes is selected, enter the processor s name and provide 3 months processing statements. If a new merchant, note appropriately. 19. Number of locations on TransFirst portfolio ONLY. If If this is the same owner with multiple locations, enter the Merchant ID (MID) for one of the existing locations on TransFirst portfolio. If this merchant is affiliated with another organization, such as a franchise, enter the MID of the affiliation. 20. Do you bill your customers prior to goods being shipped? This identifies whether the merchant has future delivery. If the merchant charges before shipment, the box indicating the length of time prior to shipping must be checked, If the purchaser does not leave the merchant location with the product; it is future delivery. Health club memberships, hotel reservations and anything else where the service is performed after the purchase, is future delivery. This changes the rating on the credit matrix. 21. What is your return and refund policy? This information will give some insight into the potential for chargebacks. 22. How do you advertise? Mark all appropriate advertising methods. 23. Please supply copies of all types of advertising including catalogs and brochures. If merchant web pages are not complete and live, please submit the developmental pages for credit to review. This does not apply to most retail brick and mortar accounts. 24. Credit Card Processing Methods Fill in appropriate percentages for how transactions are run. When added together the total of these percentages must equal 100%. For new merchants, use estimates provided by the merchant. 25. Do you ship your own goods/products? - This indicates the control that the merchant has over products sold. If they do not ship their own goods/products the name of the fulfillment house and their contact information is entered here. 26. Average VISA/MC/DISC Transaction (Ticket) Amount Average sale amount. To calculate the average sale amount take the total monthly gross sales divided by the total number of transactions. If this is a new business, enter an estimate provided by the merchant. 27. Total Monthly VISA/MC/DISC Sales Total credit card gross volume on a monthly basis. If this is a new business, enter an estimate provided by the merchant. 28. Seasonal Business If merchant is seasonal, check the box adjacent to the months the merchant is open and operating. This is important to avoid monthly service charges. If the merchant is not seasonal check no. 29. Card Types Requested Check all credit card types that are accepted at this merchant location. In many cases, merchants will want to accept all credit cards and debit cards. Dir V1. 1008 3

List the names of each of your independent contractors or agents that will have access to cardholder data, including any third party order-taking service This contractor may perform software or paper report/drafts storage. Is this contractor compliant according to VISA/MC information privacy requirements (i.e. PCI compliance)? An example of this would be hospitals that contract with a collection agency. What information is shared? BANKING INFORMATION 30. Banking Information Provide the merchant s banking information where deposits will be submitted to and fees will be taken from. 31. Please mark one box indicating the type of account to be used for ACH entries. Select the box for Checking Acct or Savings Acct. A Bank GL acct does not apply. 32. Authorization for Automatic Funds Transfer (ACH). This is the ACH statement explaining that TransFirst is authorized to initiate automatic debits or credits to the account listed previously. 33. Merchant Initials The merchant must initial this page TRADE INFORMATION 34. Bank and Trade References This section gives us information about some of the vendors the merchant uses. This provides us with references and verifies the type of business. We need to know the name of the trade reference, the account number, the product that is purchased, and the phone number. Trade references are utilized by credit to determine how stable the merchant may be. Vendors that the merchant uses are acceptable. Fee Schedule This section discloses the pricing to the MERCHANT! This lists all charges that the merchant will pay. If an item is blank, we will assume that the STW is covering that cost for the merchant. 35. Pricing Select your method of pricing a. QMS - This is Qualified/Mid/Standard, traditionally known as three tier pricing. A Qualified rate and two surcharges are quoted based on billing element tables (BET) provided by the Relationship Manager. b. Differential - This is also known as two tier pricing, combines QMS and Interchange Plus pricing to ensure costs are covered and rate increases are minimal. Please refer to your differential billing element table (BET) when pricing the surcharge amount. Also known as Differential Plus or Differential surcharge. The ISA/ISO sets the amount of the surcharge priced to the merchant. Differential expense to the merchant is charged on all transactions that would normally downgrade to Mid or Non Qualified. It is calculated by taking the actual interchange category the transaction qualifies at (i.e. EIRF 2.30%) and subtracting the Visa/MC base rate (i.e. Visa CPS Retail of 1.54%). This will calculate your "Differential" amount. The surcharge, as defined by the ISA/ISO is then added to the differential amount (i.e. 1.50%) which constitutes the "Plus" piece of the pricing program. Dir V1. 1008 4

Example: $100 Transaction that qualifies at EIRF and the merchant is on Differential plus pricing with a 1.50% surcharge. 2.30% (EIRF) -1.54% (Visa Base "CPS Retail").76% (Differential amount) +1.50% (plus or surcharge amount) 2.26% (Total downgrade %) X $100 (transaction amount) $2.26 (total downgrade cost) *Keep in mind that on both Differential and QMS pricing all transactions (100%) are charged at the qualified rate and then surcharged if downgraded. c. Intg Plus - The Interchange rates set by Visa and MasterCard are passed straight through to the merchant with a mark up for profit. It includes all dues and assessments. Each ISA/ISO has the ability to determine the "plus" portion, which is charged in addition to Visa/MC pass-through costs. 36. Discount Method - Select if qualified fees are applied Daily or Monthly Daily Discount - All transactions are billed at the qualified rate and the discount is taken out of the net batch amount deposited by the merchant on a daily basis. Monthly Discount - All fees are calculated and billed to the merchant monthly. No fees are taken out daily. 37. Fee Category V/MC/DISC cards (if applicable) The Discount Rate and per a. Qualified or Plus Rate: (Retail, MOTO, Internet) - This fee is assessed on every transaction settled. b. Check Card rebate: (Signature Based) - This is a credit for transactions using Signature Based Debit cards instead of regular credit cards. It appears at the bottom of the monthly statement with other miscellaneous fees. c. Mid-Qualified Surcharge: Retail Only - This fee is assessed on transactions that have met some but not all requirements of a qualified transaction. This charge is in addition to the qualified rate. d. Non-Qualified or Differential Surcharge: Retail, MOTO, Internet This is a fee assessed for transactions that do not meet any of the requirements for a qualified transaction. This is charged in addition to the qualified rate. 38. Transaction Fee These are charged every time the merchant uses the terminal to contact the network for an inquiry on a card whether or not an actually monetary transaction occurs. A transaction fee will also be assessed for every batch transmission. 39. Per Item Fee - Per Item Fee is only charged on a captured transaction, and does not include batch fees. The following are miscellaneous fees passed on to the merchant. 40. Application (Set-up) Fee If you choose to have TransFirst charge the merchant for an application setup fee fill out this field. TransFirst will then include your portion of the setup fee on your monthly residual payments. 41. Monthly Minimum Fee - The fee the merchant is charged to ensure the sales channel will collect at least a set amount of fees even if the merchant processes little or no Dir V1. 1008 5

transactions. If the merchant is seasonal, they will not be charged in the months that are known to be inactive 42. Monthly Statement Fee - This is the administrative charge billed for the generation of the merchant s monthly statement. 43. Annual Fee This is a fee the ISA/ISO may charge on an annual basis for services. You may set the starting date and the merchant will be billed on that date annually. 44. Voice Auth - This is the fee that is billed to the merchant if they are unable to process via their terminal and they must call for an authorization. The sale will then need to be run as a forced-sale or post-auth once the normal method of processing is once again available 45. ARU Trans Fee - This is the fee that is billed to the merchant for ALL transactions if they are TTC (touch tone capture) or Dial-Pay. 46. Batch Close Fee - This fee is charged every time the merchant batches. It is a fee for accessing the authorization network when routing the transactions for settlement. Usually the same as a transaction fee. 47. Chargeback Fee - Fee charged when a dispute is made by a cardholder or issuing bank regarding a transaction. This fee covers the costs associated with the chargeback investigation 48. Retrieval Fee - When a retrieval is requested, this is the fee to the merchant 49. Non AVS Adjustment Fee This fee is charged when address verification is not attempted on a hand-keyed transaction. This is for MOTO merchants only. 50. Monthly Merchant Club Fee - A fee charged to become a member of the TransFirst merchant club 51. Monthly TransLink Fee - - This is the merchant s monthly charge for the use of TransLink 52. Wireless per Transaction Fee - Enter the fee to be charged per transaction via wireless service. This is generally charged in addition to the standard authorization fee. 53. Monthly Wireless Gateway Fee This is the monthly service fee. This fee is for the wireless service only and is in addition to any other fees billed. 54. Wireless Setup Fee - Enter the one-time setup fee for wireless service. This is a service that allows the merchant to access the network via a wireless device that operates like a cellular phone. 55. Visa/MC Pin Based Debit Card Per Transaction Fee This is the fee that is charged for each Pin debit transaction utilizing the Visa or MC association. 56. Monthly Debit Network Fee - This is a monthly fee charged for the ability to perform Pin debit transactions. 57. Debit Card Application fee - This is a fee charged for applying for Pin debit card acceptance. 58. Network release Fee -This fee is hardcoded and cannot be changed. If you choose not to charge the fee, please cross out the amount and initial the change. Dir V1. 1008 6

59. Monthly PCI Compliance Fee This is a fee charged to ensure all of the merchant s transactions while processed through TransFirst remain PCI compliant and able to serve all merchants in a safe and secure way to reduce fraud risk. If you choose not to charge this fee, please cross out the amount and initial the change. 60. Existing AMEX # - If the merchant already has an account with American Express, enter the Amex merchant id number here. For American Express, enter the proper discount rate based on the industry type as defined on the American Express Quick reference Card. Select the Monthly Flat Fee if the merchant has less than $4999 in American Express volume. The Monthly Flat Fee is required for all Internet, Mail Order Telephone Order or Home-based business. For retail merchants check the Retail transaction fee box. Explain to the merchant that there is a 30 bp downgrade fee for card not present (CNP) transactions. For other types of merchants, select the Services, Wholesale & All Other $0.15 Trans Fee. 61. Transaction Central Processing (TransFirst s Proprietary Payment Gateway and Virtual Terminal) There are fees associated with the upkeep and processing in addition to normal processing costs. This section only applies to merchants using Transaction Central. a. Select the proper box for the version of TC being requested Transaction Central is a basic online application for credit cards only. Transaction Central Plus allows the merchant to accept credit cards and/or ACH transactions. b. Monthly Gateway fee - This is the monthly fee assessed for using TC c. TC Setup Fee - This is the fee charged for setting up an account for TC d. Per Item Fee This fee applies only for TC Plus account set up. e. Optional Peripheral Hardware Description Enter the information regarding which certified device(s) is being used with TC 62. Check Services If a merchant wishes to have check guarantee or verification, they can sign up for check services. TransFirst uses CrossCheck as a preferred partner. Cross Check provides different levels of verification and guarantee services so the merchant does not have to assume all risk on checks. Use this section for customers that are signing up for Cross Check (you do not need any additional documentation or applications). Select the level of service requested by checking the appropriate box. a. Per Transaction fee - This is the fee charged for every check submitted for verification. b. Monthly subscription fee This is the monthly charge associated with Cross Check. c. Discount Rate This is a charge applied to the Premium Guaranty service d. Monthly Minimum This is the lowest amount the merchant will be charged for Cross Check service regardless of the volume processed.. e. Application fee This fee may be applied when signing a new merchant f. Other monthly fee - Enter the amount of any additional fees here. g. Description of Fee What is the additional fee being charged? 63. Merchant Gift Card and Loyalty Program (must complete the separate TenderCard application as well) a. Select the type of gift card program being subscribed to by checking the appropriate box b. Gift Cards accepted at all locations (Y/N) - If the merchant has multiple locations, are the gift cards going to be accepted at all locations. Situations where a merchant may not accept cards at other locations may be if a special promotion is planned for a single location in order to drive more business to that specific location. Dir V1. 1008 7

c. Monthly Hosting Fee - This is the monthly charge for utilizing the program d. Per Transaction Fee - This is the cost of each use of the gift card. e. Number of gift card locations How many locations does the merchant plan on utilizing the gift card program? f. Monthly Hosting Fee for each Additional location This is the monthly charge for each additional location. g. Select ONE of the following four kits Which starter kit does the merchant wish to purchase. Enter the price being charged to the merchant. h. Additional Cards/Sleeves/Terminal/Location Fees - These fees are for product in addition to the basic service 64. Additional Services - If the merchant is signing up for any additional services, select them here by checking the appropriate box. If a box is checked, complete the associated addendum and submit. 65. Initials The merchant must initial this page. Equipment Options Deployment uses this section for the ordering of new equipment. 66. Item Description provides for terminal listing, printer types, pin pads, check readers and imprinters. Use the open box for ordering special equipment such as cables for check readers or imprinters. 67. Model Number/ID - List model of equipment 68. Version or Serial# - Version numbers or serial numbers for any software/gateway/pin pad listed are required for encryption exchange. 69. QTY - list quantity of equipment you wish to order for the merchant. 70. Code The codes are listed under the Equipment Options box, Deployment uses these codes to ensure equipment should be sent out by TransFirst to the merchant location. a. FUA Free Use Addendum - This equipment was provided for free. A free use addendum must be attached. b. MO Merchant Owned The merchant previously purchased this equipment. c. PN Purchase New The merchant is purchasing this equipment from TransFirst as part of this application. d. PO Purchased via Other Source The merchant is purchasing the equipment from another provider. e. PRF Purchased Refurbished The merchant is purchasing refurbished equipment as a part of this application. f. RTL Rental/Lease The merchant is either renting or leasing the equipment. A rental or leasing agreement is required. g. EE Encryption Exchange This is a pin pad swap with the TransFirst encryption installed. A serial# is required for this option. h. STW STW Provided - The merchant is receiving the equipment from the STW. This is not applicable for Direct Sales. 71. Price This is the total cost to the merchant. The price listed should include any markup that is applied. Shipping, handling and tax will be billed in addition to the equipment price you list here. 72. Equipment billing to If selling equipment to the merchant at cost, select merchant so the total cost of equipment plus shipping, handling, and tax are passed on correctly on the first billing statement. If marking the equipment up, select Agent so the actual cost plus shipping, handling, and tax will be passed on to the sales office and the price quoted to the merchant will appear on the first month statement. Dir V1. 1008 8

73. Ship equipment to Indicate if the ordered equipment should be shipped to the merchant s DBA or legal address. 74. Welcome Kit sent by Select Processor (TransFirst) for shipment a welcome kit. 75. Welcome Kit shipped to Indicate if the welcome kit is mailed directly to the merchant at either the BDB or Legal address. If the kit is to be shipped to a home address the, the merchant s name must be included.. 76. Merchant trained by Indicate if Agent or Processor (TransFirst) will handle the installation and training of the equipment with the merchant. 77. Name, Address, City, State and Zip Fill out if other was selected above 78. MERCHANT(S) SIGNATURE - It is required that each person who provided information in the principal section to sign in this section. 79. If a guaranty is being provided, the applicant must also sign on the guaranty line and print their name below. The signatures must be dated. TransFirst strongly encourages personal guaranties on all applications. Dir V1. 1008 9