Sps New Merchant Questionnaire Form Page 3
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1
2
3Yes
No
(RCK) Transaction based on a paper check that has been returned due to insufficient
or uncollected funds
If yes, please provide a copy of the notice displayed/provided to the consumer that a check
returned for insufficient or uncollected funds may be re-presented electronically via the
ACH network.
22) What is the transaction frequency? Check all that apply:
Yes
No
One-time / Single payment
Recurring payment
23) If processing ACH transactions, what software are you using? (check all that apply)
SPS achXPRESS
Host-to-Host Integration
Property Boss
SiteLink
ClubSoft
WinCable
ePN
Storage Commander
Other (please specify): ______________________________________
24) Where is the ultimate destination of your settlement funds?
United States
Other
If not the U.S., then please explain: __________________________________________________________________________________________
______________________________________________________________________________________________________________________________
25) What is your refund policy? __________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
26) Have you previously processed ACH transactions?
Yes
No
If yes, please provide last 60 days return rates:
Administrative Returns %
Unauthorized Returns %
Total Returns %
Please, also attach your last 3 months processing history including volume in # and $ and returns in # and $.
27) Is there anything else you would like to add that might help us properly underwrite this account and set up properly on the
front end to help avoid any potential issues with the ODFI once processing has begun? (ie. Volume seasonality, unusually
high volume days, high returns volume, etc.)
Yes
No
If yes, please explain: ________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
28) Please specify your desired debit transaction limits:
Maximum Individual Transaction: $
Maximum Daily:
$
Maximum Weekly:
$
Maximum Monthly:
$
29) Do you intend on processing credits?
Yes
No
If yes, please explain why and specify those desired limits below: ____________________________________________________________________________
Maximum Individual Transaction: $
Maximum Daily:
$
Maximum Weekly:
$
Maximum Monthly:
$
Printed Name
Title
Signature
Date
Please complete this form and return with requested documents to Secure Payment Systems. You can do so by faxing to (858) 549-
1323 (ATTN: Contracts) or as an attachment via the secure email link “SPS/APS Secure Link” on the lower right side of the SPS
website home page at
and send to
.
Thank you for your Cooperation!
10/9/15
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