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CHASE 00 Merchant Services - 4 Northeastern Boulevard, Salem., NF1 03079-1952 - wwwXhasopayraentLCII.COM <br />Phone: (603) 896-6000 - Fax: (eO3) "B-8715 - Mei,chant-Services@Gtlas-Paymentech cam <br />Please E] PiNless Debit {Not applicable larrentil merchants) <br />select the network vendors thatijwj have approval _from:NYC�EAR ©_ Pulse _[] Accel ❑ <br />El PIN Based Debit <br />PIN BASED DEBIT Requires a PIN Pad — please complete section 8, item #4, entitled "Will you be using a <br />Point -of -Sale terminal (US and Canada only) or Point -of -Sale software?" <br />If checked above, this division will be setup for the following network vendors with the exception of EBT: <br />(Pulse, NYCE, STAR, Inteffink, Maestro, ACCEL, Alaska Options, Jeanie, AFFAI, CU24) <br />EST required: Yes El or No [] ? FCS# required if processing food stamp transactions: <br />LgGt_Card (U.5. only) <br />[3 gill Me Latero payment option (us only) <br />0 European Direct Debit <br />For EURO Only.* (Valid only far Euro current y divisions) <br />Descriptor I I I I I I I I I I ] rit; bytes) <br />Default will be the first 16 characters of your Caidliolderoescripsor unless otherwise noted <br />Please select country(s) in which you will offer Direct Debit, <br />AT (Austria) 0 BE (Belgium) El DE (Germany) El NL (Nathortands)E] FP (France)E] <br />For GBP only: (valid ort far Gap currency divisions) <br />Descriptor (7bytes) <br />Default will be the first 7 characters of your Cardholder Descriptor unless otherwise noted <br />Country., UK n <br />Redeposit Parameter? El No C] Yes Indicate #of days! The default is ^1^ <br />El -P-ay —Pa I (Valid for Us currency only) <br />Payer Email Address: <br />(32 cheracterin"it) (must be a unique email address belonging rotate merchants business and must be working at the time oraccount crea creation. <br />Note, No two accounts ordivisions can share the same Payer email address.) <br />Customer Service Email Address: <br />(127 character limit) <br />Primary Contact Name: Phone: Email: <br />Descriptor LP I A I Y I P 1 (18 bytes) <br />Business Name. Customer Service Phone# (optional) <br />(75 character limit and must not contain the following characters ti, <, and >.) <br />Sales Venue: [] eBay 0 Other Marketplace Ll My own Websits(include http:) El Other <br />Avg.Transaction Price: $ Avg, TransrYr. Percent of Annual revenue from online sales: % <br />Authentication Method: (the method by which you (the merchant) wilt authenticate your customer with PayPal- you mustchasse only one <br />I follovf <br />PayPal Direct El Cardinal Commerce CentinelEj (it Cardinal Commerce is involved, please complete the follondolv): <br />Are you using Ecometry or CommercialWare Software to facilitate your Paypal Integration? YesEl No [I <br />Time Zone (based on mischani's location): —SSL Security: (check one) HTTP El or HT7PSE1 I <br />Tech Contact Name. Phone: Email Address: <br />Revl 1/18110 5 NekvDiwsmScluii/cboo <br />