MERCHANT RECEIPT
MERCHANT RECEIPT
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APPLICATION FEE (Non-Refundable) $__-0-__
LINK POINT or ECLIPSE LEASE TERMS - Equipment/Software __48__ months
LEASE PAYMENT* $_29.90_
*All leases subject to taxes, insurance and approval by a leasing company. Equipment sales are the responsibility of Agent/Sales representative and not Cardservice International.
PURCHASE AMOUNT $_-0-___ (Tax Included)
TOTAL COLLECTED $_29.90_
METHOD OF PAYMENT: Visa/MC/Amex
CREDIT CARD NUMBER___________________
EXPIRATION DATE ______/________
Name Printed on Card:
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SERVICES
MONTHLY MINIMUM $15.00
DISCOUNT RATE MID-QUALIFIED:
2.39 %
TRANSACTION FEE $0.25
ADDRESS VERIFICATION FEE $0.05
MONTHLY CUSTOMER SERVICE FEE $10.00
CardService Merchant Club $ 15.00 |
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* All lease options are through an independent leasing
company (Integrated Leasing). The leasing company will review the signer's
credit and is subject to a separate approval process. Also, all equipment
purchase options are the responsibility of the Agent (Merchant Account
Solutions Inc / Cardservice Texas) not Cardservice International.
_______________________________________ Company Name
X______________________________________ _C. Taylor__________________ Merchant Signature Date Account Representative Signature
FDIS - CardService International |
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