merchant application completion instructions

Merchant Application Completion Instructions

Page 1 is the Exhibit A Terminal Installation Form. Have the merchant complete the top-left section labeled "Terminal Location", enter the surcharge amount on "Surcharge $" line, enter the terminal make and model on "Terminal Make and Model" line, and sign at the bottom-right on "Customer Sign Off" line.
Page 2 is the Core Data Resources ACH Authorization Release. Have the merchant sign on line 19, enter the date on line 20, and print his/her name and title on line 21.
Page 3 is the ATM Location Information. Have the merchant complete from "Merchants or Business Name Where ATM is Located" through "State of Incorporation".
Page 4 is the Merchant Owned or Leased Information. Have the merchant complete as much as possible/applicable.
Page 5 is the Investigative Consumer Report. Have the merchant date, sign, and print his/her name(s).
In addition to the above paperwork, the merchant must attach:
1. An original preprinted voided check from the account to which funds are to be electronically deposited. (If an original preprinted voided check is not available, an original letter on bank letterhead from the merchant's bank stating the name on the account, account number, and bank routing number may be attached in its place.)
2. "Proof of Business", which may be provided in the form of a photocopy of the location's business license, seller's permit, or articles of incorporation (as applicable).
3. A check made payable to "Platinum Financial" in the amount of the total sales price (including sales tax, if location is in the State of California).

Mail the completed application & attachments to:

Reference Materials | Product Brochures | Marketing Materials
Contracts & Forms | Distributor Home Page | Platinum ATM Home Page