authorized merchant packet 2010 - srn communications · pdf file ·...

7
PCS Wireless Corporate 11 Vreeland Rd Florham Park, NJ (973) 805-7400 Tel www.pcsww.com Authorized Merchant Packet 2010 Contractual Agreement Commission Rates Merchant Application Please fax the following to (973) 301-0971 or email to [email protected] Completed & Signed Application Resale Tax Certificate Preprinted Business Check or Bank letter with both routing and account number

Upload: doandung

Post on 16-Mar-2018

221 views

Category:

Documents


6 download

TRANSCRIPT

Page 1: Authorized Merchant Packet 2010 - SRN Communications · PDF file · 2010-04-30Authorized Merchant Packet 2010 Contractual Agreement Commission Rates Merchant Application Please fax

PCS Wireless – Corporate 11 Vreeland Rd

Florham Park, NJ (973) 805-7400 Tel

www.pcsww.com

Authorized Merchant Packet 2010

Contractual Agreement Commission Rates Merchant Application

Please fax the following to (973) 301-0971 or email to [email protected]

Completed & Signed Application

Resale Tax Certificate

Preprinted Business Check or Bank letter with both routing and account number

marisel
Typewritten Text
Revised 01.18.2010
marisel
Typewritten Text
marisel
Typewritten Text
marisel
Typewritten Text
marisel
Typewritten Text
marisel
Typewritten Text
marisel
Typewritten Text
marisel
Typewritten Text
marisel
Typewritten Text
marisel
Typewritten Text
marisel
Typewritten Text
marisel
Typewritten Text
marisel
Typewritten Text
marisel
Typewritten Text
marisel
Typewritten Text
Page 2: Authorized Merchant Packet 2010 - SRN Communications · PDF file · 2010-04-30Authorized Merchant Packet 2010 Contractual Agreement Commission Rates Merchant Application Please fax

PCS Wireless – Corporate 11 Vreeland Rd

Florham Park, NJ (973) 805-7400 Tel

www.pcsww.com

WEBPOS & BACKOFFICE LOGIN

WebPos

https://webpos.payspot.com/pcs BackOffice http://backoffice.payspot.com PaySpot Customer Service (800) 983-9385 PCS Email [email protected]

Page 3: Authorized Merchant Packet 2010 - SRN Communications · PDF file · 2010-04-30Authorized Merchant Packet 2010 Contractual Agreement Commission Rates Merchant Application Please fax

Merchant Agreement (rev. 10/07)

Merchant Agreement

Account ID#:____________Terminal ID#:____________IBO Username:__________________

Referring Agent:______________________ Referring Account #:_______________________

Merchant Contact Information

Merchant Name:

Street Address:

City State Zip

Office # Fax # Cell#

E-mail Address Contact Person

State Sales Tax # Please attach a copy of your RTC

Bank Name: Acct# Routing#

***Please attach preprinted business check***

PIN Wizard Access Requested: yes no Terminal Request: yes no

TO BE COMPLETED BY MERCHANT (use additional sheet, if necessary)

Requested [p]inWizard identification:

User Name:

MERCHANT BANKING INFORMATION AND ACH AUTHORIZATION (MUST INCLUDE VOIDED CHECK): This Merchant Agreement

(“Agreement”) is between PaySpot, Inc. (“Company”) and "Merchant" listed above. To accommodate electronic access for settlement, Merchant does

hereby authorize and instruct Company to access Merchant's designated depository account and to initiate credit and/or debit entries by bank wire,

payment order or Automated Clearing House transfer and to authorize the banking institution ("Depository") named above to block or to initiate, if

necessary, reversing entries and adjustments for any original entries made to the depository account indicated above and to authorize Depository to

provide such access and to credit and/or debit or to block the same to such account. This authorization is without respect to the source of any funds in

the depository account, and this authority shall remain in full force and effect until Company has received written notification from Merchant of its

termination in such time and in such manner as to afford Company and Depository a reasonable opportunity to act on it. In order to insure that

transactions are properly handled, a specimen-voided check is attached. Your signature acknowledges that you are authorized to execute this

Agreement, are a signatory on the attached business check and have read and understand all information contained herein, the terms and conditions and

any addenda, amendments, or attachments, all of which are incorporated into this Agreement.

[p]inWizard: At Merchant’s request, Company will provide internet access to Merchant by means of Company’s [p]inWizard application that will

enable Merchant to purchase PINs for various prepaid services utilizing the systems and software operated by Company. Merchant agrees to

exclusively use Company’s [p]inWizard system for the internet purchase, resale and further distribution of PINs for prepaid services of any type.

Merchant agrees that Merchant is responsible for the security of assigned User Names and Passwords utilized to access Company’s [p]inWizard system

and agrees to pay Company for all PIN purchases made utilizing Merchant’s assigned User Names and Passwords. Company agrees to establish

purchase limits within its system upon Merchant’s written request. Merchant agrees that it is purchasing Company’s products (“PaySpot Products”) for

resale to end-user customers of prepaid services and that Merchant is wholly responsible for any and all sales tax obligations on all products purchased

from Company.

Investigative Consumer Report: An investigative or Consumer Report may be made and obtained in connection with this Agreement. Merchant

authorizes Company or any credit reporting agency engaged by it to investigate the references given or any statements or data obtained from Merchant

or any undersigned principal for the purposes of this Agreement.

xpuser1
Sticky Note
Unmarked set by xpuser1
xpuser1
Rectangle
xpuser1
Rectangle
ron
Note
Accepted set by ron
ron
Note
Completed set by ron
ron
Note
Completed set by ron
ron
Note
Accepted set by ron
ron
Text Box
*No fee for Pin Wizard
ron
Text Box
*Weekly fee for processing under $300 per week
ron
Text Box
$0 - $149 = $6.00 $150 - $299 = $3.00 Over $300 = NO FEE
ron
Text Box
ron
Text Box
(Password will be emailed to Merchant by PaySpot)
ron
Text Box
ron
Text Box
xpuser1
Sticky Note
Marked set by xpuser1
xpuser1
Typewritten Text
xpuser1
Typewritten Text
xpuser1
Typewritten Text
xpuser1
Typewritten Text
xpuser1
Typewritten Text
xpuser1
Typewritten Text
xpuser1
Sticky Note
MigrationConfirmed set by xpuser1
xpuser1
Sticky Note
Completed set by xpuser1
ronald.hans
Stamp
marisel
epay
Page 4: Authorized Merchant Packet 2010 - SRN Communications · PDF file · 2010-04-30Authorized Merchant Packet 2010 Contractual Agreement Commission Rates Merchant Application Please fax

ISO Agreement (rev. 10/07) PaySpot, Inc. Confidential Information

EXHIBIT E

Credit Application Information

Legal Business Name: Tax Id:

Billing Address: City: State: Zip:

Telephone #: Fax#:

Accounts Payable Contact: Payables Phone #:

Company Email Address: Payables Email Address:

Merchant ‘Doing Business As” Name:

Location Address: City: State: Zip:

Telephone #: Fax#:

Primary Contact: Email Address:

Type of Company: Corporation Sole Proprietor LLC Partnership Joint Venture Other

If other, please explain:

State of Organization: Principle Place of Business:

Dun & Bradstreet #:

Requested Credit Line: No. of Years in Business:

Principal Information

Name: Title: Percentage of Ownership:

Residence Address: City: State: Zip:

Home Telephone: Social Security #: Date of Birth:

Driver’s License #: State:

Name: Title: Percentage of Ownership:

Residence Address: City: State: Zip:

Home Telephone: Social Security #: Date of Birth:

Driver’s License #: State:

Company President: Company CFO:

Trade References

Company Name: Phone #:

Address: Fax #:

Email Address: Account #:

Company Name: Phone #:

Address: Fax #:

Email Address: Account #:

Company Name: Phone #:

Address: Fax #:

Email Address: Account #:

Bank Account Information

Bank Name: Phone #:

Address: Fax #:

Account #: ______________________________________Contact Name: ___________________________________________

An investigative, consumer or commercial report may be made in connection with this application. The undersigned authorizes PaySpot or any credit

reporting agency employed by it to investigate its personal and business history and of its principals, partners, stockholders and members and obtain

credit bureau reports for each for the purposes of this Agreement.

Acceptance:

Authorized Signing Officer: Date:

Print Name & Title:

xpuser1
pcs
marisel
epay
Page 5: Authorized Merchant Packet 2010 - SRN Communications · PDF file · 2010-04-30Authorized Merchant Packet 2010 Contractual Agreement Commission Rates Merchant Application Please fax

Product Merchant Percent Category

Boost Pins 4.00% Wireless

Boost RTR 10.00% Wireless

Boost RTR Unlimited $2.00 Wireless

ATT / Cingular Universal 14.50% Wireless

T-Mobile 13.50% Wireless

Verizon 6.50% Wireless

Virgin Mobile 5.00% Wireless

H2O 10.00% Wireless

Simple Mobile 8.00% Wireless

TracFone 9.50% Wireless

Tuyo Mobile 13.00% Wireless

Cricket By Week 9.50% Wireless

Cricket PayGo 8.50% Wireless

Net 10 9.50% Wireless

O2 GSM 12.50% Wireless

Page Plus 13.50% Wireless

Locus GSM 12.50% Wireless

Movida 8.50% Wireless

STI Mobile 11.50% Wireless

*By signing I agree to the above rates for the products being provided to me by PCS Wireless through Epay

Business Name Date

Name Signature

Agent Signature DateFOR AGENT USE ONLY

Additional Products & Discounts (Exhibit A)

*I, undersigned, hereby understand and agree that I am requesting that this terminal be placed by Epay, Inc. pursuant to my signed

Equipment Placement Contract on File, and agree to abide by the terms described therin.

1. Write VOID across the business check

2. Tape the business check over this box

3. Fax this Agreement to PCS Wireless @ (973) 301-0975 or email to [email protected]

Page 6: Authorized Merchant Packet 2010 - SRN Communications · PDF file · 2010-04-30Authorized Merchant Packet 2010 Contractual Agreement Commission Rates Merchant Application Please fax

Revised 07/2000, Page 1 of 4

TID#: 909000______________________ -OR - Agent username: _________________________________

UNIFORM SALES & USE TAX CERTIFICATE MULTIJURISDICTION

The below-listed states have indicated that this form of certificate is acceptable, subject to the notes on pages 2 - 4. The issuer and the

recipient have the responsibility of determining the proper use of this certificate under applicable laws in each state, as these may

change from time to time.

Issued to Seller: PaySpot, Inc.

Address: 4601 College Blvd., Suite 300, Leawood, KS 66211

I certify that: is engaged as a registered

Name of Firm (Buyer): Wholesaler ________________________

Retailer ___________________________

Address Manufacturer ______________________

Seller (California) ___________________

Lessor (see notes

on pages 2 - 4) _____________________

Other (Specify) _____________________

and is registered with the below listed states and cities within which your firm would deliver purchases to us and that any such

purchases are for wholesale, resale, ingredients or components of a new product or service1 to be resold, leased, or rented in the

normal course of business. We are in the business of wholesaling, retailing, manufacturing, leasing (renting) the following:

Description of Business: ___________________________________________________________________________

General description of tangible property or taxable services to be purchased from the seller:

Mobile phones, wireless PINs, long distance phone cards

State State Registration, Seller's State State Registration, Seller's

Permit, or ID Number Permit, or ID Number

of Purchaser of Purchaser

AL2 _____________________________ MO13 _____________________________

AR _____________________________ NE14 _____________________________

AZ22 ____________________________ NV _______________________________

CA 3 ____________________________ NJ ________________________________

CO 1 ____________________________ NM 1,15 ____________________________

CT4 _____________________________ NC25 ______________________________

DC5 _____________________________ ND _______________________________

FL 23_____________________________ OH26 ______________________________

GA6 _____________________________ OK16 ______________________________

HI 1,7 ____________________________ PA27 ______________________________

ID ______________________________ RI 17 ______________________________

IL 1,8 ____________________________ SC ________________________________

IA ______________________________ SD 18 ______________________________

KS ______________________________ TN _______________________________

KY 24_____________________________ TX19 ______________________________

ME9 ______________________________ UT _______________________________

MD 10 _____________________________ VT _______________________________

MI 11 ______________________________ WA 20 _____________________________

MN 12 _____________________________ WI21 ______________________________

I further certify that if any property or service so purchased tax free is used or consumed by the firm as to make it subject to a Sales

or Use Tax we will pay the tax due directly to the proper taxing authority when state law so provides or inform the seller for added

tax billing. This certificate shall be a part of each order which we may hereafter give to you, unless otherwise specified, and shall be

valid until canceled by us in writing or revoked by the city or state.

Under penalties of perjury, I swear or affirm that the information on this form is true and correct as to every material matter.

Authorized Signature: _____________________________________________________ (Owner, Partner or Corporate Officer)

Title: _____________________________________________________

Date: _____________________________________________________

Page 7: Authorized Merchant Packet 2010 - SRN Communications · PDF file · 2010-04-30Authorized Merchant Packet 2010 Contractual Agreement Commission Rates Merchant Application Please fax

PCS Wireless – Corporate

11 Vreeland Rd

Florham Park, NJ 07932

(973) 805-7400

www.pcsww.com

INDIVIDUAL PERSONAL GUARANTY

Date: ______/_______/________

I, ___________________________________, (Individual Guarantor) residing at _________________________ (home

address) for and inconsideration of PCS Wireless LLC (“PCS”) providing products and/ or services at my request,

receipt of which is hereby acknowledged, to__________________________ (Company Name) (hereinafter referred

to as “Company”) of which I am ____________________ (Title), hereby personally unconditionally guarantee to

PSC, its successors and assigns, payment of any obligations of the Company and I hereby agree to jointly and

severally bind myself to pay PCS on demand any sum which may become due to PCS by the Company. It is

understood that this guaranty shall be continuing in nature and revocable only upon formal written consent

by the CFO of PCS. Such revocation shall not apply to existing indebtedness but only on obligations arising

subsequent thereto. In the event an action is commenced to enforce my obligations under this Personal

Guaranty, I hereby agree to indemnify PCS for all attorney fees, court fees, and all other associated expenses.

I have read this Personal Guaranty and understand the contents thereof.

Signature: ______________________ SSN: ________________________

Witness: ______________________ Address: ________________________