Sps New Merchant Questionnaire Form Page 2
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36) If you are a Third Party Collection Agency, describe your typical Customer clients (ie. Medical, Credit Card, Auto Loan,
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Mortgage, Commercial debt holders, etc.):
__________________________________________________________________________________
17) If you are a Third Party Collection Agency, are you or any of your customers processing debt related to Payday Loan
companies or Debt Consolidators?
Yes
No
If yes, please explain: ________________________________________________________________________________________________________
18) Who do you offer or sell your Products or Services to? Check all that apply:
Yes
No
Consumers
Businesses
19) How are your Products or Services offered or sold to your Customer? Check all that apply:
Yes
No
Storefront
Online
Outbound Telemarketing Sales
Inbound Customer Initiated Telephone Sales
20) Does the business have a Website? Yes
No
If yes, Website Address: _____________________________________________________________________________________________________
21) How does your business plan on processing payments with SPS? Check all that apply:
Yes
No
(ARC) Single entry debit based on check received by mail, drop box, or at a manned bill
payment location for conversion to ACH via check reading device
If yes, please provide a copy of the notice that is provided to the customer notifying them
that their check may be converted to ACH.
(BOC) Single entry debit based on check presented at point-of-purchase or manned bill
payment location for conversion to ACH during back office processing via check reading
device
If yes, please provide a copy of the notice that is provided to the customer notifying them
that their check may be converted to ACH.
(CCD) B2B ACH entries. (Debits or Credits to Business/Merchant bank accounts)
If yes, please provide a sample copy of your B2B(Busines-to-Business) agreement.
(POP) Single entry debit based on check presented at point-of-purchase or manned bill
payment location for conversion to ACH via check reading device
If yes, please provide a copy of the terminal receipt.
(PPD) Transaction based on consumer’s written / signed authorization or either single
entry or recurring debits
If yes, please provide a copy of the customer ACH debit authorization form.
(TEL) Transaction authorized via the telephone
If yes, please provide CSR script and IVR script (if utilizing automated system) as well as a
copy of the payment confirmation sent to the consumer. If processing “recurring” TEL
transactions, please also provide an audio recording of a sample TEL transaction.
(WEB) Transaction authorized via the Internet (i.e. Merchant’s website)
If yes, please provide screenshots of the payment process including terms and conditions
pages. Also, provide a copy of your annual data security audit as required by NACHA to
st
be completed by December 31
every year.
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Parent category: Business