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CHASE CF Merchant Services - 4 Northeastern Boulevard, Salem, NH 03079-1952 . www.chasepaymentech.com + Paymentech Phone: (603) 896-6000 - Fax: (603) 896.8715 + Marchant—Services@ChasePaymentech.com 4: Please check below if applicable: M Bill Payment (A Bill Payment transaction is a transaction loran ongoing service/billing cycle that is known and agreed upon In advance by the merchant and cardholder, i.e. Membership or Insurance, etc.) Do you stock product? ❑ Yes M No Do you provide custom orders at time of sale? ❑ Yes M No Do you own the product at the time of sale? M Yes ❑ No Do you drop ship the product? ❑ Yes M No If yes, what %: Are you filling your own merchandise orders? M Yes ❑ No If no, who is your fulfillment service bureau? Fulfillment Contact: Phone # : SECTION Sil CHARGEBACKCONTACT: (required) IQA(Manager/eupenvisor-one who assigns work toMCAs) (Required for retail and Discover) MRQA (Manager/supervisor= one who assigns work to MRAs) NOTE: This contact may receive, any exception documents that may;: need tc be mailed or faxed, if not participating in Chargeback Management this will be the default contact for Chat ebaok Mallin second mret ct will not be required)' Location: ❑ Merchant ® Submitter ❑ Fulfillment (check one) If Submitter/Fulfillment, Name: M Mr. ❑ Mrs. ❑ Ms. First Name: John Last Name: Morabito Title; GTO Phone #: 703-825-3525 Ext: Fax #: 877-256-8330 Alternate Fax #: Email Address: jmorabito@invoicecloud.com Address: 1815 Beulah Rd City: Vienna Si VA Zip/Postal Code: 22182 Country: USA Will this contact require access to: Transaction History ❑ Report Center ❑ both M ? Account Masking for this contact? M Yes ❑ NO Does this contact have a Paymentech Online User ID? ❑Yes MNo If yes, provide User ID: CHARG&ACK CQNTACM (required) MCA (Merchant Chargeback Analyst one who works the chargeback's) Mequilred fbr ivlatl and Discover) MRA Merchant Retrieval Andlyst— qne who`works the _retrievals M Same as above (check here if the MCA/MRA Contact is the same as the IQA/MRQA contact) Location: ❑ Merchant ❑ Submitter ❑ Fulfillment (check one) If Submitter/Fulflllment, Name: ❑ Mr. ❑ Mrs. ❑ Ms. First Name: Last Name: Title: Phone #: Ext: Fax #: Alternate Fax #: Email Address: Address: City: State/Prov: _ Zip/Postal Code: Country: Will this contact require access to: Transaction History [❑ Report Center ❑ both ❑ ? Account Masking for this contact? ❑ Yes ❑ No Does this contact have a Paymentech Online User ID? ❑Yes []No If yes, provide User ID: Ravi 1/18/10 3 NewDivisienSetup/cboo