Merchant Service Application

Merchant Service Application and Business Agreement

RECITALS

WHEREAS, Merchant Name: operates the business identified in this application and seeks to obtain payment processing services from Processor Name: ; and

WHEREAS, Processor will evaluate the merchant's transaction profile, risk, and documentation and, subject to acceptance, provide acquiring, settlement and ancillary services under the terms set forth in this application and the attached agreement; and

WHEREAS, Merchant certifies that all information provided herein is true and authorizes Processor to verify any information, obtain consumer or business credit reports where permitted, and to seek banking and processing references as necessary.

APPLICANT (MERCHANT) INFORMATION

Corporation    LLC    Partnership    Sole Proprietor

PRINCIPAL / OWNER INFORMATION (List all individuals owning 25% or more)

PROCESSING PROFILE

Estimated Monthly Card Volume:    Average Ticket:    Largest Single Ticket:

Primary Processing Method:    Card Present (Retail)    E‑commerce    MOTO / Phone Order

Average Monthly Chargeback Rate (if applicable):    Anticipated Card Present %:

BANKING / SETTLEMENT (ACH) DETAILS

PROCESSING HISTORY & RISK DISCLOSURES

Has the business experienced chargebacks exceeding 1.5% in the last 12 months?    Yes    No

Has the merchant or principals filed for bankruptcy, had a merchant account closed for cause, or been indicted for fraud?    Yes    No

SCOPE OF WORK

The Processor shall provide acquiring, authorization, settlement, and risk monitoring services necessary to accept credit and debit card transactions for the Merchant's business as described below. Merchant hereby requests the services described and agrees to provide all required documentation and reasonable cooperation.

PAYMENT TERMS

Merchant agrees to pay fees, charges and assessments as set forth in this application and any separately executed fee schedule. Fees may include interchange, assessment, processor markups, chargeback fees, monthly account fees, equipment rental or purchase fees, and other applicable amounts.

TERM AND TERMINATION

The term of the services shall commence on: Start Date: and shall continue until End Date: unless earlier terminated in accordance with this Agreement.

Either party may terminate this Agreement for convenience upon written Notice Period (days): . Processor may terminate immediately for cause upon discovery of material misrepresentation, suspected fraud, excessive chargebacks, or violation of card brand rules.

CONFIDENTIALITY

Each party agrees that any non-public business, technical or financial information disclosed by one party to the other in connection with this application and related services will be held in confidence and used solely to perform obligations under this Agreement. Confidential information does not include information that is or becomes public without breach, is independently developed, or is required to be disclosed by law.

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the state of: without regard to conflict of law principles. Venue for any dispute shall be in the courts located within that state unless otherwise required by applicable card brand rules.

ENTIRE AGREEMENT

This application, together with any fee schedule, addenda and the Processor's standard merchant agreement incorporated herein by reference, constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior discussions, proposals and agreements. No amendment will be effective unless in writing and signed by both parties.

AUTHORIZATION AND CERTIFICATIONS

The undersigned certifies under penalty of perjury that the information provided is true, complete and correct. Merchant authorizes Processor to obtain business and personal credit reports, to verify banking and processing relationships, and to share information with card brands, acquirers, and risk-monitoring providers as necessary for onboarding and ongoing services. Merchant acknowledges that providing false or misleading information is grounds for immediate account denial or termination and may subject Merchant to civil or criminal liability.

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