2023-04-26_ali.malik_Elavon SAT Questionnaire.docx

(Company Name) Questionnaire

Business Information

Ownership Information

Please list any individuals that have 25% or more ownership in the company. If there is no one with 25% or more ownership, please list the individual that will be signing

Owner 1/Authorized Signer

Owner 2

Owner 3

Owner 4

Credit Card Volumes

If doing CAD and USD, please fill in both tables

Card Acceptance

Please list below what email you would like the statements to be sent to

DBA Name

DBA Address

Legal Name

Legal Address (if different from DBA)

Ownership Type

Business Identification Number (Tax ID/W8BEN)

Country of Formation

Country of Primary Business Operations

Description of product/service

Business Establishment Year

Length of Ownership

Funding in CAD/USD

Business Phone Number

Business Email

Contact Name

Name

Home Address

Ownership Percentage

DOB

Title

Phone Number

Email Address

SSN (for US signer only)

Name

Home Address

Ownership Percentage

DOB

Title

Phone Number

Email Address

Name

Home Address

Ownership Percentage

DOB

Title

Phone Number

Email Address

Name

Home Address

Ownership Percentage

DOB

Title

Phone Number

Email Address

Company Annual Revenue

Projected Monthly Card Sales

Average Transaction Amount

Amex Monthly Volume

Amex Average Transaction Amount

Highest Ticket

Frequency of High Ticket

CAD/USD

Company Annual Revenue

Projected Monthly Card Sales

Average Transaction Amount

Amex Monthly Volume

Amex Average Transaction Amount

Highest Ticket

Frequency of High Ticket

CAD/USD

Do you have an existing account with Amex?

If yes, please provide the account number

Seasonal?

Card Present/ Card Not Present/ Internet?

Which card types will you be accepting? (MC, Visa, Discover, Amex)

Out of 100 cards, how many are Mastercard?

Out of 100 cards, how many are Visa?

Out of 100 cards, how many are Amex?