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CHASE ill Merchant Services • 4 Northeastern Boulevard, Salem, NH 03079-1952 . www.chasepaymentech,com Payrnelitech Phone: (603) 896-6000 • Fax: (603) 896.8715 • Merchant_Services@ChasePaymentech.com SECTION 4: 1099K CONTACT INFORMATION (II required ifnew USentityand/or taxpayer ID, WSrequlredfor Canadian Transaction Division's Taxpayer ID #/No. 95.6000785 Same as Corporate Yes ❑ No 1099K Contact Name This Is the contact It Francisco Gutierrez 1099K Contact email address : fgutierrez@santa-ana.org Division Name: City of Santa Ana - Dog License (up to 30 bytes - this will appear on your Financial Reports) Currency (list only 1 each per division): Presentment: us Settlement: US **` If using our Cross Currency Product — please provide both the Presentment and the Settlement Currencies • The following Feld appears on the customer's statement and identifies the merchant name for the consumer and credit card organizations. To further aid consumer recognition, Visa has sanctioned the abbreviation of the merchant name, it must be separated from product information by an asterisk (*), which must appear In the 4th, 8th or 13th position The asterisk cannot be used for Retail Merchants. Internet service providers, e-wmmerce merchants may utilize a URL instead of Customer Service Phone If not processing any Mall -order transactions (URL must only be 13 bytes) Cardholder Descriptor (Forall card types with the exception of American Express): e » G i t y o f S a In t a A n I a I 1 1 (22 bytes) Customer Service Phone #: 7 1 4 6 4 7 5 4 0 0 (13 bytes) (Required for Mall Order or Recurring) City: (Required for Retail) (13 bytes) URL: (optional, If phone# provided above) 4-1 4 (13 bytes) Division Location Address: 20 Civic Center Plaza, Country: USA (Must be a street. address, PO Boxes not acceptable) Ctty: SantaAna StafelProv: C A Zip Code (US): EEaT77o 1 (For Retail -City above must match City Location) Postal Code (Intl): I � I I I Postal Code (Can): (6 bytes) (State/Province and PostallLlp codes must match the address given above) Product/Service Description (Enter product description, to clothing, D0 g L 1 c e n S e books, membership) Publication Descriptor (Please provide on/yif required by your submitter): E� Avg. Trans. $ Amt: 25 Avg. # Trans./Yr: 3000 Projected Refund % 10 BPS How do you market this product? (Check only those that apply to this division) ❑ Catalog ❑ Direct Mail ® Internet ❑ Space Ad ❑ TV ❑ Outbound Telemarketing ❑ Other How will consumers provide credit card information to you when they order this product? (Select only one): El Retail ❑Mail/Phone(MarketingMaterial Required) ®Internet(Pleaseprovide your URL)rhttp:// wwwlnvoicecloud.com/santa- ana If internet is selected and the wobsito is not yet available to consumers please complete a Marketing Material Supplement form which you may obtain from Merchant Services or your account executive. If internet, please advise: Select one: ® SSL ❑ SET ❑ No encryption method Will the consumer be able to place their order and provide their credit card info (or electronic check info) through this website? ® Yes ❑ No Is the web site secure, i.e„ will the information that the consumer provides, such as their name and credit card number be encrypted so that it can't be read or intercepted by other people? ®Yes ❑No Maximum Sale $125k Transaction Amount: (Default $25,000 U.S. dollars or established international currency equivalent per transaction) Maximum Refund $125k Transaction Amount: (Default $25,000 U.S. dollars or established international currency equivalent per transaction) (Approval will be required for any temporary of permanent Increases to this ceiling limp). Please check the consumer's payment option for this division: (Select only one): ®Single payment []Installment payments ❑Deferred payments ❑Recurring (transactions managed by merchantisubmitter) Rev11 /18/10 2 NewDivlslonSetup/cboo