Payment Gateway Get Exclusive Payment Gateway from Navotar Fill out the form below to start today! Name of Entity (Legal Name) City State / Province Telephone # (Landline) Business Site URL Corporate / Billing Address Country --- Postal Code Email ID: How Long in Present Business? (Years / Months) Authorised Contact Name Visa/Mastercards Card Swipe E-Commerce Average Ticket VISA / DISCOVER / MASTERCARD Monthly Volume Amex AMEX Monthly Volume High Ticket AMEX Average Ticket Opt out of AMEX Marketing Communication MO/TO QUESTIONNAIRE 1.What percentage of sales are to: Business Clients? Individual Consumer? 2.Method of Marketing Other 3.Ecommerce Merchants - % of customer base: %US %Canada %Other 4. Visa/Mastercard/Discover card sales are charged to the card on: if Other (Specify): 5. Do you require deposits? If yes, % of total sales: OR Flat fee: Is Final payment due before fulfillment? If yes, how many days before final delivery? 6. Does any of your billing or marketing strategy involve negative response, or automatic billing? If yes, explain: 7. Do you offer a product/Service Warranty or Guarantees? If yes, is it 8. If Refund, is it: Other 9. Does your business charge recurring billing to customers? 10. Does your business offer up-sells? If yes, please provide the company names associated with the up-sells: 11. How is the card payment information entered into the payment system? Other. 12. If credit card payment information is taken over the Internet is payment channel encrypted by SSL or better? 13. Do you own the product/inventory? Is the product stored at your business location? If No, where is it stored? 14. Who ships the product? Contact Name: Phone Number Zip Plus4 City State Street Number Street Name Unit Designator Unit/Suite/Apt/Floor 15. Method of Delivery If Other: 16. How long after payment is product delivered?% of Sales in Same Day % of Sales in 1-3 Days % of Sales in 4-7 Days % of Sales in 8-14 Days % of Sales in 15-30 Days % of Sales in 30+ Days Merchant Certificate # Certificate Issuer Expiry Date
