Team Vision Partner Application Agents Application - Team Vision Basic Contact InformationName HiddenReferral Partner*Team VisionHiddenLead Source*Web FormEmail Company PhoneHome Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Legal Business InformationLegal Business Name Business Incorporation Type (LLC, S Corp, Corp, etc..) Federal Tax ID Age of the Business Average Ticket Amount Average Monthly Volume Legal Business Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Is Your Business Doing-Business-As Another Name? Yes No Doing-Business-As Name Doing-Business-As Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Website Description of Business ServicesPayment InformationUpload Scanned Image of a Blank CheckMax. file size: 64 MB.Bank Name Bank Routing Number Bank Account Number Daily Batch Settlement Time : Hours Minutes AM PM Funding Options Next Day 2 Day Funding Account Guarantor InformationLegal Owner Name Job Title Ownership Percentage Personal Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Social Security Scanned Image of Government Issued ID Drop files here or Select files Max. file size: 64 MB. TechnologiesDesired Method(s) of Accepting Payments Phone Line Terminal Internet Connected Terminal Wireless Terminal Virtual Terminal Ecommerce Mobile Phone Swiper Point of Sale Terminal InformationAdditional InformationProcessing PricingVisa/MasterCard/Discover/AMEX Rate (Basis Points) Transaction Discount Rate Gateway Fee (if applicable) Batch Settlement Fee Monthly Statement Fee Monthly Minimum Processing Annual IRS Mandate Compliance Monthly Gateway Fee PCI Compliance Fee POS PricingPOS Setup Fee (If Applicable) POS Monthly Fee (If applicable)
