Netdeposit Merchant Application

Total Transact Setup (For Credit Card and ACH Processing)

APPLICATION INSTRUCTIONS

CREDIT CARD UNDERWRITING While we will not perform a credit check for merchants that want to use our payment processing system for credit cards only, we will need to comply with our Know Your Customer, Patriot Act, Anti-Money Laundering and Anti-Terrorist Policies and perform a back ground check. This includes checking the authorized individuals SS# and Driver’s License number against a series of data bases that provide us with the necessary information. This will not affect the authorized individual’s credit.

ACH, E-Check and RDC UNDERWRITING Merchants who wish to process eCheck, and/or RDC (check) payments through our payment processing system must apply for a Merchant Account by completing the following Merchant Application and submitting the application with the supplementary documentation listed below. Federal law requires that all financial services companies obtain, verify, and record information that identifies each person and business entity that opens a merchant account. The information requested will be used to process the application and will be kept confidential.

ADDITIONAL DOCUMENTATION IMPORTANT Please make sure that the authorized individual’s contact information is the same person that signs the application. Please provide the following information: Authorized Individual’s Signature (please make sure that the authorized individuals contact information is the same person that signs Copy of the Authorized Individual’s Driver’s License For each bank account specified on this app, please include a copy of a voided check or bank letter that clearly identifies the bank name, account holder, routing number, and account number. Starter checks are not allowed. **Depending upon credit worthiness and length of time in business, we reserve the right to request additional information on a case-by-case scenario.

PRODUCT USAGE DEFINITIONS Select the products (eCheck, Card, and/or RDC) and the features you wish to use. The features are defined as: • Virtual Terminal (VT) – Enables merchant to process telephone, mailed-in, and/or face-to-face payments. • Recurring Payments (RP) – Enables merchant to setup and manage installment or recurring payments. • Online Payment Page (OPP) – Allows merchant to accept payment from its customers via the Internet. • PayForward (PF) – Provides merchant ability to originate eCheck payments to vendors, customers, and/or employees. • API/Web Services (WS) – Enables merchants to initiate payments, manage customer payment information, and report payment status via HTTPS POST or Web Services interfaces. Appropriate for IT-savvy merchants or technology channel partners who want responsibility for the user experience. • Batch Payment Request File (BPRF) – Allows merchants to submit eCheck and Card payments using BankServ-proprietary batch file or eCheck payments using NACHA file format. Batch files can be uploaded via Web browser or SFTP. • Batch Reporting File (BPF) – Provides merchants with batch file-based reports on eCheck, Card, and RDC transactions (e.g., processed, disbursed, and returned Items). • Swipe Card Terminal (SCT) – Enables merchants to process face-to-face, card present payments. Requires a card reader. • Remote Deposit Capture (RDC) – Enables merchants to capture physical checks and electronically deposit them at BankServ. Requires a supported check scanner.

Completed applications and supplemental information may be faxed to VMS at 877-885-1740 or email to [email protected] .

1 Rev111027 Total Transact Setup (For Credit Card and ACH Processing)

RESELLER INFORMATION

Reseller ID Reseller Name Date

Sales Agent ID Sales Agent Business Phone Email