www.boostb2b.com
Open in
urlscan Pro
192.124.249.120
Public Scan
Submitted URL: http://www.boostb2b.com/pfm2017
Effective URL: https://www.boostb2b.com/card-processing-agreement-wp-pr/?Card_Processing_Agreement__c.SF_Campaign__c=Mastercard
Submission: On May 18 via api from US — Scanned from DE
Effective URL: https://www.boostb2b.com/card-processing-agreement-wp-pr/?Card_Processing_Agreement__c.SF_Campaign__c=Mastercard
Submission: On May 18 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
POST https://sfapi.formstack.io/FormEngine/EngineFrame/UploadFile
<form action="https://sfapi.formstack.io/FormEngine/EngineFrame/UploadFile" enctype="multipart/form-data" id="form1" method="post" target="ffIframe"><input id="userTimeZone" name="userTimeZone" type="hidden" value="0"><input id="txtHtmlId"
name="txtHtmlId" type="hidden" value="dsysfhJ-r4T_tklQo7SCBA"><input id="txtSendSizeChange" name="txtSendSizeChange" type="hidden" value=""><input id="txtObjId" name="txtObjId" type="hidden" value=""><input id="txtOrgId" name="txtOrgId"
type="hidden" value="XnmsLoI4ITz4znMUt8iXfWxdwp63ASqzc4iSYcfgmyA"><input id="txtAuthToken" name="txtAuthToken" type="hidden" value=""><input id="txtRefreshToken" name="txtRefreshToken" type="hidden"
value="qODTv-jgtpTfs7akNPBgfg9BOD7UwRdSiZBLmfQgOxkI-IWMlKC96I5GuZtKnz7gQncR-0NHP2THQyiAqLovludaSZvbZWY1DZik2FLQ0PoYHmGMLK5a0kGA2asO0VSy"><input id="txtAccessURI" name="txtAccessURI" type="hidden" value=""><input id="txtSessionID"
name="txtSessionID" type="hidden" value="cld5qpJ1cVIf6dy7e8gX8y1TWkgcQbNAEeWAWcLT4MzbKe_H6FarDTg8BQIZerS3"><input id="txtSubmittedData" name="txtSubmittedData" type="hidden" value=""><input id="formHtml" name="formHtml" type="hidden"
value=""><input data-val="true" data-val-required="The Boolean field is required." id="multipageEnabled" name="multipageEnabled" type="hidden" value="False"><input data-val="true" data-val-required="The Boolean field is required."
id="breadcrumbEnabled" name="breadcrumbEnabled" type="hidden" value="False"><input data-val="true" data-val-required="The Boolean field is required." id="breadcrumbNumbered" name="breadcrumbNumbered" type="hidden" value="False"><input
id="breadcrumbPrefix" name="breadcrumbPrefix" type="hidden" value=""><input id="submitMessage" name="submitMessage" type="hidden" value="Thank you for your submission!"><input id="submitUrl" name="submitUrl" type="hidden"
value="https://boostb2b.com/thank-you-card-processing-application-submitted/"><input id="submitBtnText" name="submitBtnText" type="hidden" value="Submit Application"><input id="prevBtnText" name="prevBtnText" type="hidden" value="Back"><input
id="nextBtnText" name="nextBtnText" type="hidden" value="Next"><input id="pageValType" name="pageValType" type="hidden" value="form"><input id="txtUserContentId" name="txtUserContentId" type="hidden" value=""><input data-val="true"
data-val-required="The Boolean field is required." id="hasCustomCSS" name="hasCustomCSS" type="hidden" value="True"><input id="isCurrentForm" name="isCurrentForm" type="hidden" value=""><input id="packageTier" name="packageTier" type="hidden"
value=""><input data-val="true" data-val-required="The Boolean field is required." id="isDraft" name="isDraft" type="hidden" value="False"><input data-val="true" data-val-required="The Boolean field is required." id="saveForLaterEnabled"
name="saveForLaterEnabled" type="hidden" value="False"><input id="saveBtnText" name="saveBtnText" type="hidden" value="Save"><input id="discardBtnText" name="discardBtnText" type="hidden" value="Discard"><input id="draftSaved" name="draftSaved"
type="hidden" value=""><input id="draftEmail" name="draftEmail" type="hidden" value=""><input id="paymentType" name="paymentType" type="hidden" value=""><input id="formName" name="formName" type="hidden" value="CPA - WorldPay - 0.54%"><input
id="CommunityInstanceURL" name="CommunityInstanceURL" type="hidden" value=""><input id="CommunitySessioID" name="CommunitySessioID" type="hidden" value=""><input id="CommunityUserId" name="CommunityUserId" type="hidden" value=""><input
id="CommunityUserType" name="CommunityUserType" type="hidden" value=""><input id="CommunityViewMode" name="CommunityViewMode" type="hidden" value=""><input id="comPrefillDataset" name="comPrefillDataset" type="hidden" value=""><input
id="prefillDataset" name="prefillDataset" type="hidden" value=""><input id="comPrefillObj" name="comPrefillObj" type="hidden" value=""><input id="hfFileServiceEndpoint" name="hfFileServiceEndpoint" type="hidden"
value="https://sfapi.formstack.io"><input id="hfFileServiceApiKey" name="hfFileServiceApiKey" type="hidden" value="8fc5982e-6eca-4d73-a3ff-997902b163b0-20212151122"><input id="reCaptchaV3token" name="reCaptchaV3token" type="hidden"
value=""><input id="submissionWorkflowId" name="submissionWorkflowId" type="hidden" value="">
<div id="dvBannerHTML" runat="server">
<script language="javascript" type="text/javascript">
function evaluateRules(lstRules, source) {
if (arguments.length > 0) {
for (var i = 0; i < lstRules.length; i++) {
switch (lstRules[i]) {
case 1:
if ((FFEqualTo('Card_Processing_Agreement__c.Appropriate_Entity__c', 'Private Corporation', false, source)) || (FFEqualTo('Card_Processing_Agreement__c.Appropriate_Entity__c', 'Limited Liability Company', false, source))) {
FFShowField('Card_Processing_Agreement__c.Beneficial_Owners_25_or_more__c', source);
FFShowField('FileUploadArea580', source);
} else {
FFHideField('Card_Processing_Agreement__c.Beneficial_Owners_25_or_more__c', source);
FFHideField('FileUploadArea580', source);
}
break;
case 2:
if ((FFEqualTo('Card_Processing_Agreement__c.Beneficial_Owners_25_or_more__c', 'Yes', false, source))) {
FFShowField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_City__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_State__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_Zip_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Date_of_Birth__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_SSN__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_Select_Ownership_Percentage__c', source);
FFShowField('Card_Processing_Agreement__c.More_Beneficial_Owners_1__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_City__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_State__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_Zip_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Date_of_Birth__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_SSN__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_Select_Ownership_Percentage__c', source);
FFHideField('Card_Processing_Agreement__c.More_Beneficial_Owners_1__c', source);
}
break;
case 3:
if ((FFEqualTo('Card_Processing_Agreement__c.More_Beneficial_Owners_1__c', 'Yes', false, source)) && (FFEqualTo('Card_Processing_Agreement__c.Beneficial_Owners_25_or_more__c', 'Yes', false, source))) {
FFShowField('Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_2_City__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_2_State__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_2_Zip_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_2_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Date_of_Birth__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_2_or_Control_Manager_SSN__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_2_Select_Ownership_Percentage__c', source);
FFShowField('Card_Processing_Agreement__c.More_Beneficial_Owners_2__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_2_City__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_2_State__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_2_Zip_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_2_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Date_of_Birth__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_2_or_Control_Manager_SSN__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_2_Select_Ownership_Percentage__c', source);
FFHideField('Card_Processing_Agreement__c.More_Beneficial_Owners_2__c', source);
}
break;
case 4:
if ((FFEqualTo('Card_Processing_Agreement__c.More_Beneficial_Owners_2__c', 'Yes', false, source)) && (FFEqualTo('Card_Processing_Agreement__c.More_Beneficial_Owners_1__c', 'Yes', false, source)) && (FFEqualTo(
'Card_Processing_Agreement__c.Beneficial_Owners_25_or_more__c', 'Yes', false, source))) {
FFShowField('Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_3_City__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_3_State__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_3_Zip_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_3_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Date_of_Birth__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_3_or_Control_Manager_SSN__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_3_Select_Ownership_Percentage__c', source);
FFShowField('Card_Processing_Agreement__c.More_Beneficial_Owners_3__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_3_City__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_3_State__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_3_Zip_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_3_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Date_of_Birth__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_3_or_Control_Manager_SSN__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_3_Select_Ownership_Percentage__c', source);
FFHideField('Card_Processing_Agreement__c.More_Beneficial_Owners_3__c', source);
}
break;
case 5:
if ((FFEqualTo('Card_Processing_Agreement__c.More_Beneficial_Owners_3__c', 'Yes', false, source)) && (FFEqualTo('Card_Processing_Agreement__c.More_Beneficial_Owners_2__c', 'Yes', false, source)) && (FFEqualTo(
'Card_Processing_Agreement__c.More_Beneficial_Owners_1__c', 'Yes', false, source)) && (FFEqualTo('Card_Processing_Agreement__c.Beneficial_Owners_25_or_more__c', 'Yes', false, source))) {
FFShowField('Card_Processing_Agreement__c.Owner_4_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_4_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_4_City__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_4_State__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_4_Zip_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_4_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_4_Date_of_Birth__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_4_Social_Security_Number__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_4_Percentage_Ownership__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Owner_4_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_4_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_4_City__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_4_State__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_4_Zip_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_4_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_4_Date_of_Birth__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_4_Social_Security_Number__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_4_Percentage_Ownership__c', source);
}
break;
case 6:
if ((FFEqualTo('Card_Processing_Agreement__c.Beneficial_Owners_25_or_more__c', 'No', false, source))) {
FFShowField('Card_Processing_Agreement__c.Controlling_Manager_Executive_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Controlling_Manager_Executive_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_City__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_State__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_Zip_Code_Postal_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Controlling_Manager_Executive_DOB__c', source);
FFShowField('Card_Processing_Agreement__c.Controlling_Manager_Executive_SSN__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_Percentage_Owernship__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Controlling_Manager_Executive_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Controlling_Manager_Executive_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_City__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_State__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_Zip_Code_Postal_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Controlling_Manager_Executive_DOB__c', source);
FFHideField('Card_Processing_Agreement__c.Controlling_Manager_Executive_SSN__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_Percentage_Owernship__c', source);
}
break;
case 7:
if ((FFEqualTo('Card_Processing_Agreement__c.Appropriate_Entity__c', 'Public Corporation', false, source))) {
FFShowField('Card_Processing_Agreement__c.Stock_Exchange_Ticker_Symbola__c', source);
FFShowField('Card_Processing_Agreement__c.Authorized_Signatory_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Authorized_Signatory_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Authorized_Signatory_City__c', source);
FFShowField('Card_Processing_Agreement__c.Authorized_Signatory_State__c', source);
FFShowField('Card_Processing_Agreement__c.Authorized_Signatory_Zip_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Authorized_Signatory_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Authorized_Signatory_Phone__c', source);
FFShowField('Card_Processing_Agreement__c.Authorized_Signatory_Title__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Stock_Exchange_Ticker_Symbola__c', source);
FFHideField('Card_Processing_Agreement__c.Authorized_Signatory_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Authorized_Signatory_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Authorized_Signatory_City__c', source);
FFHideField('Card_Processing_Agreement__c.Authorized_Signatory_State__c', source);
FFHideField('Card_Processing_Agreement__c.Authorized_Signatory_Zip_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Authorized_Signatory_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Authorized_Signatory_Phone__c', source);
FFHideField('Card_Processing_Agreement__c.Authorized_Signatory_Title__c', source);
}
break;
case 8:
if ((FFEqualTo('Card_Processing_Agreement__c.Appropriate_Entity__c', 'Non-Profit', false, source))) {
FFShowField('Card_Processing_Agreement__c.Type_of_Nonprofit__c', source);
FFShowField('Card_Processing_Agreement__c.Region_where_services_are_performed__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_City__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_State__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_Zip_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_Phone__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_Date_of_Birth__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_Social_Security__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Type_of_Nonprofit__c', source);
FFHideField('Card_Processing_Agreement__c.Region_where_services_are_performed__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_City__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_State__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_Zip_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_Phone__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_Date_of_Birth__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_Social_Security__c', source);
}
break;
case 9:
if ((FFEqualTo('Card_Processing_Agreement__c.Appropriate_Entity__c', 'Sole Proprietor', false, source))) {
FFShowField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_City__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_State__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_Zip_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Date_of_Birth__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_SSN__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_City__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_State__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_Zip_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Date_of_Birth__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_SSN__c', source);
}
break;
case 10:
if ((FFEqualTo('Card_Processing_Agreement__c.More_Beneficial_Owners_1__c', 'No', false, source)) || (FFEqualTo('Card_Processing_Agreement__c.More_Beneficial_Owners_2__c', 'No', false, source)) || (FFEqualTo(
'Card_Processing_Agreement__c.More_Beneficial_Owners_3__c', 'No', false, source)) || (FFEqualTo('Card_Processing_Agreement__c.More_Beneficial_Owners_3__c', 'Yes', false, source))) {
FFShowField('Card_Processing_Agreement__c.Controlling_Manager_Executive_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Controlling_Manager_Executive_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_City__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_State__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_Zip_Code_Postal_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Controlling_Manager_Executive_DOB__c', source);
FFShowField('Card_Processing_Agreement__c.Controlling_Manager_Executive_SSN__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_Percentage_Owernship__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Controlling_Manager_Executive_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Controlling_Manager_Executive_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_City__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_State__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_Zip_Code_Postal_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Controlling_Manager_Executive_DOB__c', source);
FFHideField('Card_Processing_Agreement__c.Controlling_Manager_Executive_SSN__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_Percentage_Owernship__c', source);
}
break;
}
}
} else {
if ((FFEqualTo('Card_Processing_Agreement__c.Appropriate_Entity__c', 'Private Corporation', false, source)) || (FFEqualTo('Card_Processing_Agreement__c.Appropriate_Entity__c', 'Limited Liability Company', false, source))) {
FFShowField('Card_Processing_Agreement__c.Beneficial_Owners_25_or_more__c', source);
FFShowField('FileUploadArea580', source);
} else {
FFHideField('Card_Processing_Agreement__c.Beneficial_Owners_25_or_more__c', source);
FFHideField('FileUploadArea580', source);
}
if ((FFEqualTo('Card_Processing_Agreement__c.Beneficial_Owners_25_or_more__c', 'Yes', false, source))) {
FFShowField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_City__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_State__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_Zip_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Date_of_Birth__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_SSN__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_Select_Ownership_Percentage__c', source);
FFShowField('Card_Processing_Agreement__c.More_Beneficial_Owners_1__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_City__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_State__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_Zip_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Date_of_Birth__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_SSN__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_Select_Ownership_Percentage__c', source);
FFHideField('Card_Processing_Agreement__c.More_Beneficial_Owners_1__c', source);
}
if ((FFEqualTo('Card_Processing_Agreement__c.More_Beneficial_Owners_1__c', 'Yes', false, source)) && (FFEqualTo('Card_Processing_Agreement__c.Beneficial_Owners_25_or_more__c', 'Yes', false, source))) {
FFShowField('Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_2_City__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_2_State__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_2_Zip_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_2_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Date_of_Birth__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_2_or_Control_Manager_SSN__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_2_Select_Ownership_Percentage__c', source);
FFShowField('Card_Processing_Agreement__c.More_Beneficial_Owners_2__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_2_City__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_2_State__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_2_Zip_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_2_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Date_of_Birth__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_2_or_Control_Manager_SSN__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_2_Select_Ownership_Percentage__c', source);
FFHideField('Card_Processing_Agreement__c.More_Beneficial_Owners_2__c', source);
}
if ((FFEqualTo('Card_Processing_Agreement__c.More_Beneficial_Owners_2__c', 'Yes', false, source)) && (FFEqualTo('Card_Processing_Agreement__c.More_Beneficial_Owners_1__c', 'Yes', false, source)) && (FFEqualTo(
'Card_Processing_Agreement__c.Beneficial_Owners_25_or_more__c', 'Yes', false, source))) {
FFShowField('Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_3_City__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_3_State__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_3_Zip_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_3_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Date_of_Birth__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_3_or_Control_Manager_SSN__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_3_Select_Ownership_Percentage__c', source);
FFShowField('Card_Processing_Agreement__c.More_Beneficial_Owners_3__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_3_City__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_3_State__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_3_Zip_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_3_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Date_of_Birth__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_3_or_Control_Manager_SSN__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_3_Select_Ownership_Percentage__c', source);
FFHideField('Card_Processing_Agreement__c.More_Beneficial_Owners_3__c', source);
}
if ((FFEqualTo('Card_Processing_Agreement__c.More_Beneficial_Owners_3__c', 'Yes', false, source)) && (FFEqualTo('Card_Processing_Agreement__c.More_Beneficial_Owners_2__c', 'Yes', false, source)) && (FFEqualTo(
'Card_Processing_Agreement__c.More_Beneficial_Owners_1__c', 'Yes', false, source)) && (FFEqualTo('Card_Processing_Agreement__c.Beneficial_Owners_25_or_more__c', 'Yes', false, source))) {
FFShowField('Card_Processing_Agreement__c.Owner_4_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_4_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_4_City__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_4_State__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_4_Zip_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_4_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_4_Date_of_Birth__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_4_Social_Security_Number__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_4_Percentage_Ownership__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Owner_4_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_4_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_4_City__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_4_State__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_4_Zip_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_4_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_4_Date_of_Birth__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_4_Social_Security_Number__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_4_Percentage_Ownership__c', source);
}
if ((FFEqualTo('Card_Processing_Agreement__c.Beneficial_Owners_25_or_more__c', 'No', false, source))) {
FFShowField('Card_Processing_Agreement__c.Controlling_Manager_Executive_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Controlling_Manager_Executive_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_City__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_State__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_Zip_Code_Postal_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Controlling_Manager_Executive_DOB__c', source);
FFShowField('Card_Processing_Agreement__c.Controlling_Manager_Executive_SSN__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_Percentage_Owernship__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Controlling_Manager_Executive_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Controlling_Manager_Executive_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_City__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_State__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_Zip_Code_Postal_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Controlling_Manager_Executive_DOB__c', source);
FFHideField('Card_Processing_Agreement__c.Controlling_Manager_Executive_SSN__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_Percentage_Owernship__c', source);
}
if ((FFEqualTo('Card_Processing_Agreement__c.Appropriate_Entity__c', 'Public Corporation', false, source))) {
FFShowField('Card_Processing_Agreement__c.Stock_Exchange_Ticker_Symbola__c', source);
FFShowField('Card_Processing_Agreement__c.Authorized_Signatory_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Authorized_Signatory_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Authorized_Signatory_City__c', source);
FFShowField('Card_Processing_Agreement__c.Authorized_Signatory_State__c', source);
FFShowField('Card_Processing_Agreement__c.Authorized_Signatory_Zip_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Authorized_Signatory_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Authorized_Signatory_Phone__c', source);
FFShowField('Card_Processing_Agreement__c.Authorized_Signatory_Title__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Stock_Exchange_Ticker_Symbola__c', source);
FFHideField('Card_Processing_Agreement__c.Authorized_Signatory_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Authorized_Signatory_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Authorized_Signatory_City__c', source);
FFHideField('Card_Processing_Agreement__c.Authorized_Signatory_State__c', source);
FFHideField('Card_Processing_Agreement__c.Authorized_Signatory_Zip_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Authorized_Signatory_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Authorized_Signatory_Phone__c', source);
FFHideField('Card_Processing_Agreement__c.Authorized_Signatory_Title__c', source);
}
if ((FFEqualTo('Card_Processing_Agreement__c.Appropriate_Entity__c', 'Non-Profit', false, source))) {
FFShowField('Card_Processing_Agreement__c.Type_of_Nonprofit__c', source);
FFShowField('Card_Processing_Agreement__c.Region_where_services_are_performed__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_City__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_State__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_Zip_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_Phone__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_Date_of_Birth__c', source);
FFShowField('Card_Processing_Agreement__c.Principal_Control_Person_Social_Security__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Type_of_Nonprofit__c', source);
FFHideField('Card_Processing_Agreement__c.Region_where_services_are_performed__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_City__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_State__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_Zip_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_Phone__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_Date_of_Birth__c', source);
FFHideField('Card_Processing_Agreement__c.Principal_Control_Person_Social_Security__c', source);
}
if ((FFEqualTo('Card_Processing_Agreement__c.Appropriate_Entity__c', 'Sole Proprietor', false, source))) {
FFShowField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_City__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_State__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_Zip_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Date_of_Birth__c', source);
FFShowField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_SSN__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_City__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_State__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_Zip_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Date_of_Birth__c', source);
FFHideField('Card_Processing_Agreement__c.Owner_1_or_Control_Manager_SSN__c', source);
}
if ((FFEqualTo('Card_Processing_Agreement__c.More_Beneficial_Owners_1__c', 'No', false, source)) || (FFEqualTo('Card_Processing_Agreement__c.More_Beneficial_Owners_2__c', 'No', false, source)) || (FFEqualTo(
'Card_Processing_Agreement__c.More_Beneficial_Owners_3__c', 'No', false, source)) || (FFEqualTo('Card_Processing_Agreement__c.More_Beneficial_Owners_3__c', 'Yes', false, source))) {
FFShowField('Card_Processing_Agreement__c.Controlling_Manager_Executive_Name__c', source);
FFShowField('Card_Processing_Agreement__c.Controlling_Manager_Executive_Address__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_City__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_State__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_Zip_Code_Postal_Code__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_Email__c', source);
FFShowField('Card_Processing_Agreement__c.Controlling_Manager_Executive_DOB__c', source);
FFShowField('Card_Processing_Agreement__c.Controlling_Manager_Executive_SSN__c', source);
FFShowField('Card_Processing_Agreement__c.Control_Person_Percentage_Owernship__c', source);
} else {
FFHideField('Card_Processing_Agreement__c.Controlling_Manager_Executive_Name__c', source);
FFHideField('Card_Processing_Agreement__c.Controlling_Manager_Executive_Address__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_City__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_State__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_Zip_Code_Postal_Code__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_Email__c', source);
FFHideField('Card_Processing_Agreement__c.Controlling_Manager_Executive_DOB__c', source);
FFHideField('Card_Processing_Agreement__c.Controlling_Manager_Executive_SSN__c', source);
FFHideField('Card_Processing_Agreement__c.Control_Person_Percentage_Owernship__c', source);
}
}
}
</script><input type="hidden" id="submitRules" value="">
<div>
<style>
/*Ned's update*/
label#GENERALTEXT561 {
font-size: 22px !important;
color: #3079BB !important;
}
label#GENERALTEXT737 {
font-size: 22px !important;
color: #3079BB !important;
}
label#GENERALTEXT284 {
font-size: 15px https: //www.boostb2b.com/booststprates/!important;
}
label#GENERALTEXT26 {
font-size: 15px !important;
}
/*End of Ned's code*/
label {
display: inline;
}
.ff-form-main {
padding: 0 24px 24px !important;
}
.ff-group-row>.ff-item-row:first-child {
display: none;
}
#dvFastForms .ff-group-row {
margin: -13px 24px 0 !important;
}
#dvFastForms .ff-group-row>.ff-item-row:not(:first-child),
#dvFastForms .ff-payment-wrapper,
#dvFastForms .ff-esignature-wrapper {
max-width: 50%;
}
#dvFastForms .ff-page-header {
font-family: Helvetica;
color: rgba(89, 93, 100, 1);
font-size: 28px;
}
#dvFastForms .ff-page-header-row {
border-width: 0px;
padding: 24px;
}
.ff-logo {
padding: 1px;
}
.ff-header {
padding: 0px;
}
.ff-form-main {
background-color: rgba(255, 255, 255, 1);
margin: auto;
max-width: 100%;
border-style: solid;
border-color: rgba(255, 255, 255, 1);
border-width: 0px;
padding: 24px;
}
#dvFastForms .ff-group-row {
background-color: rgba(255, 255, 255, 1);
border-width: 0px;
max-width: 100%;
padding: 0px;
margin: 24px 24px 0;
}
#dvFastForms .ff-section-header {
font-family: Helvetica;
color: rgba(89, 93, 100, 1);
font-size: 28px;
}
#dvFastForms .ff-footer-group {
padding: 0 23px;
}
#dvFastForms .ff-col-2.ff-field-col {
max-width: 100%;
width: 100%;
clear: left;
margin-top: 5px;
}
#dvFastForms .ff-label,
#dvFastForms .ff-footnote-label {
font-family: Verdana;
font-size: 13px;
}
#dvFastForms .ff-label {
color: rgba(89, 93, 100, 1);
}
#dvFastForms .ff-label-col {
padding: 5px;
}
#dvFastForms .ff-field-col {
font-family: Helvetica;
font-size: 12px;
}
#dvFastForms .ff-field-col,
#dvFastForms .ff-rating-widget a {
color: rgba(89, 93, 100, 1);
}
#dvFastForms .ff-type-text,
#dvFastForms .ff-textarea,
#dvFastForms select.ff-select-type,
#dvFastForms .ff-fileupload-drop-area,
#dvFastForms .select2-container .select2-choice,
#dvFastForms .select2-container .select2-choices {
border-style: solid;
border-radius: 5px;
border-color: rgba(8, 121, 191, 0.43);
border-width: 1px;
padding: 12px;
}
#dvFastForms .ff-textarea {
height: 38px;
}
#dvFastForms .ff-item-row .ff-type-text:not(.ff-creditcard),
#dvFastForms .ff-textarea,
#dvFastForms .ff-fileupload-drop-area {
width: 100%;
}
#dvFastForms select.ff-select-type:not(.ff-mm):not(.ff-yyyy),
#dvFastForms .select2-container {
width: 100%;
}
#dvFastForms div.ff-select-to-checkbox-list,
#dvFastForms div.ff-select-to-radiobtn-list {
width: 100%;
}
#dvFastForms .ff-rating-widget {
width: 100%;
}
#dvFastForms .ff-field-col.ff-captcha img,
#dvFastForms .ff-field-col.ff-captcha .ff-input-type {
width: 100%;
}
#dvFastForms .ff-invalid-msg {
font-family: Helvetica;
color: rgba(150, 0, 8, 1);
padding: 12px;
}
#dvFastForms .ff-required-mark {
font-family: Helvetica;
color: rgba(92, 96, 100, 1);
font-size: 16px;
}
#dvFastForms .ff-page-bread-header {
background-color: rgba(237, 239, 240, 1);
}
#dvFastForms .ff-page-bread-item {
font-family: Helvetica;
color: rgba(102, 102, 102, 1);
font-size: 14px;
}
#dvFastForms .ff-page-bread-item:hover {
color: rgba(70, 70, 70, 1);
}
#dvFastForms .ff-page-bread-item.item-selected {
color: rgba(89, 93, 100, 1);
}
#dvFastForms .ff-page-bread {
padding: 7px;
}
#dvFastForms .ff-btn-submit {
background-color: rgba(5, 121, 191, 1);
font-family: "Montserrat", sans-serif;
color: rgba(255, 255, 255, 1);
font-size: 16px;
border-style: none;
border-radius: 10px;
border-width: 29px;
font-weight: 300;
text-transform: uppercase;
letter-spacing: 1px;
border-radius: 30px 30px 30px 30px;
padding: 21px 21px 21px 21px;
}
#dvFastForms .ff-btn-submit:hover {
background-color: rgba(18, 30, 37, 1);
}
#dvFastForms .ff-alink:hover {
color: rgba(70, 70, 70, 1);
}
#dvFastForms .ff-alink {
font-family: Helvetica;
font-weight: bold;
text-decoration: underline;
color: rgba(102, 102, 102, 1);
font-size: 14px;
padding: 22px;
}
#dvFastForms .ff-col-2.ff-field-col {
max-width: 95%;
width: 100%;
clear: left;
}
#dvFastForms .btnDiv {
text-align: center;
}
.ff-item-row.fw-row {
max-width: 100% !important;
}
#dvFastForms .ff-group-row>.ff-item-row:not(:first-child),
#dvFastForms .ff-payment-wrapper,
#dvFastForms .ff-esignature-wrapper {
margin-bottom: 10px;
}
.ff-label-col label#GENERALTEXT646,
.ff-label-col label#GENERALTEXT82,
.ff-label-col label#GENERALTEXT466,
.ff-label-col label#GENERALTEXT97 {
font-size: 15px;
}
/*Tooltip Code Start*/
.ff-col-1.ff-label-col {
position: relative;
width: 93%;
}
.ff-item-row {
overflow: visible;
}
label#lblLeadATT_Account_Number_2__c::after,
label#lblLeadATT_Billing_Address_2__c+span::after,
label#lblLeadVendor_ID_2__c+span::after,
label#lblLeadClient_Name_2__c+span::after,
label#lblLeadATT_Billing_Entity_2__c+span::after,
label#lblLeadATT_Account_Number__c::after,
label#lblLeadATT_Billing_Address__c+span::after,
label#lblLeadVendor_ID__c+span::after,
label#lblLeadClient_Name__c+span::after,
label#lblLeadATT_Billing_Entity__c+span::after,
label#lblFileUpload10+span::after,
label#lblCard_Processing_Agreement__cAddress_CPA__c+span::after,
label#lblCard_Processing_Agreement__cSettlement_Option__c+span::after,
label#lblCard_Processing_Agreement__cAuthorized_Signatory_Name__c+span::after,
label#lblCard_Processing_Agreement__cAuthorized_Signatory_Address__c+span::after,
label#lblCard_Processing_Agreement__cOwner_1_or_Control_Manager_Address__c+span::after,
label#lblCard_Processing_Agreement__cOwner_1_or_Control_Manager_SSN__c+span::after,
label#lblCard_Processing_Agreement__cType_of_Nonprofit__c+span::after,
label#lblCard_Processing_Agreement__cPrincipal_Control_Person_Name__c+span::after,
label#lblCard_Processing_Agreement__cControlling_Manager_Executive_Address__c+span::after,
label#lblCard_Processing_Agreement__cControlling_Manager_Executive_SSN__c+span::after,
label#lblCard_Processing_Agreement__cMore_Beneficial_Owners_1__c+span::after,
label#lblCard_Processing_Agreement__cOwner_2_or_Control_Manager_Address__c+span::after,
label#lblCard_Processing_Agreement__cBeneficial_Owners_25_or_more__c+span::after,
label#lblCard_Processing_Agreement__cOwner_3_or_Control_Manager_Address__c+span::after,
label#lblCard_Processing_Agreement__cOwner_1_or_Control_Manager_SSN__c+span::after,
label#lblCard_Processing_Agreement__cOwner_2_or_Control_Manager_SSN__c+span::after,
label#lblCard_Processing_Agreement__cOwner_3_or_Control_Manager_SSN__c+span::after,
label#lblCard_Processing_Agreement__cMore_Beneficial_Owners_1__c+span::after,
label#lblCard_Processing_Agreement__cMore_Beneficial_Owners_2__c+span::after,
label#lblCard_Processing_Agreement__cMore_Beneficial_Owners_3__c+span::after,
label#lblCard_Processing_Agreement__cOwner_2_Select_Ownership_Percentage__c+span::after,
label#lblCard_Processing_Agreement__cOwner_1_Select_Ownership_Percentage__c+span::after,
label#lblCard_Processing_Agreement__cOwner_3_Select_Ownership_Percentage__c+span::after,
label#lblCard_Processing_Agreement__cOwner_4_Percentage_Ownership__c+span::after,
label#lblCard_Processing_Agreement__cControl_Person_Percentage_Owernship__c+span::after,
label#lblFileUpload580+span::after,
label#lblCard_Processing_Agreement__cPrincipal_Control_Person_Address__c+span::after,
label#lblCard_Processing_Agreement__cPrincipal_Control_Person_Social_Security__c+span::after,
label#lblCard_Processing_Agreement__cControlling_Manager_Executive_Name__c+span::after {
content: url('https://go.boostb2b.com/l/492571/2022-02-01/2653rkr/492571/1643752717hKig3Lag/question.png');
position: absolute;
z-index: 2;
padding: 2px 5px;
}
label#lblLeadATT_Account_Number_2__c:hover::after,
label#lblLeadATT_Billing_Address_2__c+span:hover::after,
label#lblLeadVendor_ID_2__c+span:hover::after,
label#lblLeadClient_Name_2__c+span:hover::after,
label#lblLeadATT_Billing_Entity_2__c+span:hover::after,
label#lblLeadATT_Account_Number__c:hover::after,
label#lblLeadATT_Billing_Address__c+span:hover::after,
label#lblLeadVendor_ID__c+span:hover::after,
label#lblLeadClient_Name__c+span:hover::after,
label#lblLeadATT_Billing_Entity__c+span:hover::after,
label#lblFileUpload10+span:hover::after,
label#lblCard_Processing_Agreement__cSettlement_Option__c+span:hover::after,
label#lblCard_Processing_Agreement__cAddress_CPA__c+span:hover::after,
label#lblCard_Processing_Agreement__cAuthorized_Signatory_Name__c+span:hover::after,
label#lblCard_Processing_Agreement__cAuthorized_Signatory_Address__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_1_or_Control_Manager_Address__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_1_or_Control_Manager_SSN__c+span:hover::after,
label#lblCard_Processing_Agreement__cType_of_Nonprofit__c+span:hover::after,
label#lblCard_Processing_Agreement__cPrincipal_Control_Person_Name__c+span:hover::after,
label#lblCard_Processing_Agreement__cControlling_Manager_Executive_Address__c+span:hover::after,
label#lblCard_Processing_Agreement__cControlling_Manager_Executive_SSN__c+span:hover::after,
label#lblCard_Processing_Agreement__cBeneficial_Owners_25_or_more__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_2_or_Control_Manager_Address__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_3_or_Control_Manager_Address__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_3_or_Control_Manager_Address__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_1_or_Control_Manager_SSN__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_2_or_Control_Manager_SSN__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_3_or_Control_Manager_SSN__c+span:hover::after,
label#lblCard_Processing_Agreement__cMore_Beneficial_Owners_1__c+span:hover::after,
label#lblCard_Processing_Agreement__cMore_Beneficial_Owners_2__c+span:hover::after,
label#lblCard_Processing_Agreement__cMore_Beneficial_Owners_3__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_2_Select_Ownership_Percentage__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_1_Select_Ownership_Percentage__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_3_Select_Ownership_Percentage__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_4_Percentage_Ownership__c+span:hover::after,
label#lblCard_Processing_Agreement__cControl_Person_Percentage_Owernship__c+span:hover::after,
label#lblFileUpload580+span:hover::after,
label#lblCard_Processing_Agreement__cPrincipal_Control_Person_Address__c+span:hover::after,
label#lblCard_Processing_Agreement__cPrincipal_Control_Person_Social_Security__c+span:hover::after,
label#lblCard_Processing_Agreement__cControlling_Manager_Executive_Name__c+span:hover::after {
background-color: #dddddd;
color: black;
padding: 11px;
border-radius: 9px;
font-size: 11px;
top: 0%;
z-index: 998;
max-width: 100%;
width: 90%;
right: 0;
}
label#lblLeadATT_Account_Number_2__c:hover::after {
content: 'Number is typically 5-13 digits long and must include any "leading zeros" (ie. 07893582094) Include only one account number, you will have the option to add additional account numbers later in this form.';
}
label#lblLeadATT_Billing_Address_2__c+span:hover::after {
content: 'Not customer address.';
}
label#lblLeadVendor_ID_2__c+span:hover::after {
content: 'AT&T Vendor ID # In Payer System.';
}
label#lblLeadClient_Name_2__c+span:hover::after {
content: 'Payer Name.';
}
label#lblLeadATT_Billing_Entity_2__c+span:hover::after {
content: 'AT&T Entity Noted on AT&T Bill.';
}
label#lblLeadATT_Account_Number__c:hover::after {
content: 'Number is typically 5-13 digits long and must include any "leading zeros" (ie. 07893582094) Include only one account number, you will have the option to add additional account numbers later in this form.';
}
label#lblLeadATT_Billing_Address__c+span:hover::after {
content: 'Not customer address.';
}
label#lblLeadVendor_ID__c+span:hover::after {
content: 'AT&T Vendor ID # In Payer System.';
}
label#lblLeadClient_Name__c+span:hover::after {
content: 'Payer Name.';
}
label#lblLeadATT_Billing_Entity__c+span:hover::after {
content: 'AT&T Entity Noted on AT&T Bill.';
}
label#lblFileUpload10+span:hover::after {
content: 'We cannot accept banking information on the company’s own letterhead. The voided check or bank information on bank letterhead should be scanned and saved as a PDF file and uploaded below. Boost maintains strict protocols for information and data security as well as confidentiality and privacy.';
}
label#lblCard_Processing_Agreement__cSettlement_Option__c+span:hover::after {
content: '"Net Settle is the most popular funding option and provides the net of the payment amount after any card fees are deducted. There is no debit required. The Gross/Net Settle option deposits the full amount of the payment into the bank account and debits out the fees on the same day. It is a bit easier to reconcile, but requires the company to provide Boost the ability to debit the applicable bank account. Boost will provide a remittance report to let the merchant know the invoices paid on the day after the payment is submitted by the buyer. Boost will also provide an enhanced remittance report on the expected day of funding that shows the gross amount funded, the card fees and the net amount of the payment, typically broken out by invoice. Reconciliation will be straightforward with whichever funding method you choose."';
}
label#lblCard_Processing_Agreement__cAddress_CPA__c+span:hover::after {
content: 'A physical address is required, a PO Box is not permitted';
}
label#lblCard_Processing_Agreement__cAuthorized_Signatory_Name__c+span:hover::after {
content: 'FinCEN is the body responsible for enforcing the Bank Secrecy Act (BSA), which requires financial institutions to verify that the individuals and businesses applying for accounts are who they say they are, and to prevent criminals and terrorists from gaining access to the payments system. Publicly traded companies in the United States are excluded from the definition of a legal entity customer and thus are not required to provide beneficial ownership information per FinCEN’s 31 CFR § 1010.230. Though, the KYC information for a minimum of one Authorized Signatory who has substantial control over the organization is still required.';
}
label#lblCard_Processing_Agreement__cAuthorized_Signatory_Address__c+span:hover::after {
content: "A business address may be used in lieu of a residential address."
}
label#lblCard_Processing_Agreement__cOwner_1_or_Control_Manager_Address__c+span:hover::after {
content: "A business address may be used in lieu of a residential address."
}
label#lblCard_Processing_Agreement__cOwner_1_or_Control_Manager_SSN__c+span:hover::after {
content: "If the owner does not have a US-issued SSN or TIN, a passport number will suffice."
}
label#lblCard_Processing_Agreement__cType_of_Nonprofit__c+span:hover::after {
content: "A Nonprofit Corporation has filed Articles of Incorporation with a secretary of state or corporation’s office. Unlike a Nonprofit Corporation, a Nonprofit Association is not required to file organizational papers for recognition by the state in which the association operates."
}
label#lblCard_Processing_Agreement__cPrincipal_Control_Person_Name__c+span:hover::after {
content: "We are required to collect identifying information for an individual who can exercise significant control over the company."
}
label#lblCard_Processing_Agreement__cControlling_Manager_Executive_Address__c+span:hover::after {
content: "A business address may be used in lieu of a residential address."
}
label#lblCard_Processing_Agreement__cControlling_Manager_Executive_SSN__c+span:hover::after {
content: "If the Principal/Control Person is non-US and does not have a US-issued SSN or TIN, a passport number will suffice."
}
label#lblCard_Processing_Agreement__cBeneficial_Owners_25_or_more__c+span:hover::after {
content: "FinCEN is the body responsible for enforcing the Bank Secrecy Act (BSA), which requires financial institutions to verify that the individuals and businesses applying for accounts are who they say they are, and to prevent criminals and terrorists from gaining access to the payments system. FinCEN refers to beneficial owners as the individuals who “own, control, and profit from companies when those companies open accounts.” The rule requires financial institutions to verify the identity of everyone who owns 25% or more of a business opening an account, as well as one person who manages or controls the business if it is not controlled by an owner or if there is no owner. Although the FinCEN requirement applies to financial institutions, banks pass along KYC requirements to Boost as their payment facilitator contractually. That means that Boost is responsible for adhering to the beneficial ownership rule and why we are asking for this information. Beneficial owners cannot be an entity, they must be a natural person."
}
label#lblCard_Processing_Agreement__cMore_Beneficial_Owners_1__c+span:hover::after,
label#lblCard_Processing_Agreement__cMore_Beneficial_Owners_2__c+span:hover::after,
label#lblCard_Processing_Agreement__cMore_Beneficial_Owners_3__c+span:hover::after {
content: "We are required to gather minimum KYC information for such beneficial owners with 25% or greater ownership."
}
label#lblCard_Processing_Agreement__cOwner_2_or_Control_Manager_Address__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_3_or_Control_Manager_Address__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_3_or_Control_Manager_Address__c+span:hover::after {
content: "A business address may be used in lieu of a residential address."
}
label#lblCard_Processing_Agreement__cOwner_1_or_Control_Manager_SSN__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_2_or_Control_Manager_SSN__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_3_or_Control_Manager_SSN__c+span:hover::after {
content: "If the Owner is non-US and does not have a US-issued SSN or TIN, a passport number will suffice."
}
label#lblCard_Processing_Agreement__cOwner_2_Select_Ownership_Percentage__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_1_Select_Ownership_Percentage__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_3_Select_Ownership_Percentage__c+span:hover::after,
label#lblCard_Processing_Agreement__cOwner_4_Percentage_Ownership__c+span:hover::after {
content: 'Enter a numeric value between 1-100, do not include the "%" symbol';
}
label#lblCard_Processing_Agreement__cControl_Person_Percentage_Owernship__c+span:hover::after {
content: 'Enter a numeric value, do not include the "%" symbol. If the Control Person does not have an ownership stake, please enter 0.'
}
label#lblFileUpload580+span:hover::after {
content: "As a Payment Facilitator, Boost is required to verify that our merchants are bona fide businesses. As such, for TIN/EIN verification we require entities to provide an IRS-issued document containing the entity's TIN/EIN."
}
label#lblCard_Processing_Agreement__cPrincipal_Control_Person_Address__c+span:hover::after {
content: "A business address may be used in lieu of a residential address.";
}
label#lblCard_Processing_Agreement__cPrincipal_Control_Person_Social_Security__c+span:hover::after {
content: "If the Principal/Control Person is non-US and does not have a US-issued SSN or TIN, a passport number will suffice.";
}
label#lblCard_Processing_Agreement__cControlling_Manager_Executive_Name__c+span:hover::after {
content: "The Control Person may be the same person as a beneficial owner."
}
@media only screen and (max-width: 800px) {
label#lblLeadATT_Account_Number_2__c:hover::after,
label#lblLeadATT_Billing_Address_2__c+span:hover::after,
label#lblLeadVendor_ID_2__c+span:hover::after,
label#lblLeadClient_Name_2__c+span:hover::after,
label#lblLeadATT_Billing_Entity_2__c+span:hover::after,
label#lblLeadATT_Account_Number__c:hover::after,
label#lblLeadATT_Billing_Address__c+span:hover::after,
label#lblLeadVendor_ID__c+span:hover::after,
label#lblLeadClient_Name__c+span:hover::after,
label#lblFileUpload10+span:hover::after,
label#lblLeadATT_Billing_Entity__c+span:hover::after,
label#lblCard_Processing_Agreement__cSettlement_Option__c+span:hover::after,
label#lblCard_Processing_Agreement__cAddress_CPA__c+span:hover::after,
lblCard_Processing_Agreement__cAuthorized_Signatory_Name__c+span:hover::after {
right: 0px !important;
}
}
/*Tooltip Code End*/
@media only screen and (max-width: 600px) {
#dvFastForms .ff-group-row>.ff-item-row:not(:first-child),
#dvFastForms .ff-payment-wrapper,
#dvFastForms .ff-esignature-wrapper {
max-width: 100%;
}
}
/*New form styling*/
label#GENERALTEXT579.ff-label {
font-size: 22px;
color: #3079BB;
}
label#GENERALTEXT794.ff-label,
label#GENERALTEXT516.ff-label,
label#GENERALTEXT87.ff-label,
label#GENERALTEXT940.ff-label {
font-size: 22px;
color: #3079BB;
padding-top: 30px;
display: block;
}
label#GENERALTEXT307.ff-label {
color: #3079BB;
}
/*Hide Require At Bottom of Page*/
span.requiredSpan.ff-footnote.ff-required-mark,
label.ff-footnote-label.ff-label {
font-size: 0 !important;
color: #fff !important;
}
</style>
<div class="ff-form-main">
<div id="ffOverlay"></div>
<div id="ffPage68" class="ff-page-row page-1" data-pagetitle="Page Title">
<div class="ff-group-row group-0" id="ffSection0">
<div class="ff-item-row">
<div class="ff-col-1 ff-section-col"><label class="ff-section-header" id="sectionLabel0"></label></div>
</div>
<div class="ff-item-row fw-row">
<div class="ff-col-1 ff-label-col"><label id="GENERALTEXT848" class="ff-label ff-general-text-label" vatt="STRING" data-ishidden="false"> * - Required Field <p><img
src="https://go.boostb2b.com/l/492571/2022-02-01/2653rkr/492571/1643752717hKig3Lag/question.png" width="15"> - More information</p></label></div>
</div>
<div class="ff-item-row fw-row">
<div class="ff-col-1 ff-label-col"><label id="GENERALTEXT579" class="ff-label ff-general-text-label" vatt="STRING" data-ishidden="false">Section 1- Company Contact Information</label></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Legal_Name_Of_Supplier__c" class="ff-label" id="lblCard_Processing_Agreement__cLegal_Name_Of_Supplier__c">Legal Name Of Supplier</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Legal_Name_Of_Supplier__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Legal_Name_Of_Supplier__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="false" data-vatt="STRING"></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.DBA__c" class="ff-label" id="lblCard_Processing_Agreement__cDBA__c">DBA (required if different than Legal Name)</label></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.DBA__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.DBA__c" vatt="STRING" class="ff-input-type ff-type-text"
data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isupsert="false" data-ishidden="false" data-vatt="STRING"></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="TEXTAREA" for="Card_Processing_Agreement__c.Address_CPA__c" class="ff-label" id="lblCard_Processing_Agreement__cAddress_CPA__c">Physical Address</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><textarea id="Card_Processing_Agreement__c.Address_CPA__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Address_CPA__c" vatt="TEXTAREA" class="ff-textarea"
data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-ishtmlformatted="false" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="false"
data-vatt="TEXTAREA"></textarea></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.City_CPA__c" class="ff-label" id="lblCard_Processing_Agreement__cCity_CPA__c">City</label><span class="requiredSpan ff-required-mark">*</span>
</div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.City_CPA__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.City_CPA__c" vatt="STRING" class="ff-input-type ff-type-text"
data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="false"
data-vatt="STRING"></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Country_CPA__c" class="ff-label" id="lblCard_Processing_Agreement__cCountry_CPA__c">Country</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Country_CPA__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Country_CPA__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="false" data-vatt="STRING"></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.State_CPA__c" class="ff-label" id="lblCard_Processing_Agreement__cState_CPA__c">State</label><span class="requiredSpan ff-required-mark">*</span>
</div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.State_CPA__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.State_CPA__c" vatt="STRING" class="ff-input-type ff-type-text"
data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="false"
data-vatt="STRING"></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Postal_ZIP_Code_CPA__c" class="ff-label" id="lblCard_Processing_Agreement__cPostal_ZIP_Code_CPA__c">Postal/ZIP Code</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Postal_ZIP_Code_CPA__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Postal_ZIP_Code_CPA__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="false" data-vatt="STRING"></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Phone_CPA__c" class="ff-label" id="lblCard_Processing_Agreement__cPhone_CPA__c">Phone</label><span class="requiredSpan ff-required-mark">*</span>
</div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Phone_CPA__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Phone_CPA__c" vatt="STRING" class="ff-input-type ff-type-text"
data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="false"
data-vatt="STRING"></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Website__c" class="ff-label" id="lblCard_Processing_Agreement__cWebsite__c">Website</label><span class="requiredSpan ff-required-mark">*</span>
</div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Website__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Website__c" vatt="STRING" class="ff-input-type ff-type-text"
data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="false"
data-vatt="STRING"></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="PICKLIST" for="Card_Processing_Agreement__c.Current_Visa_Or_MasterCard__c" class="ff-label" id="lblCard_Processing_Agreement__cCurrent_Visa_Or_MasterCard__c">Does your business currently
accept a commercial credit card for B2B payments (P Card or Virtual card, not a consumer or corporate card)</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col">
<div class="ff-select-to-radiobtn-list custom-flex-control-container">
<ul id="ulCard_Processing_Agreement__c.Current_Visa_Or_MasterCard__c" class="ff-select-to-radiobtn-ul ff-ext-vertical" role="radiogroup" aria-labelledby="lblCard_Processing_Agreement__cCurrent_Visa_Or_MasterCard__c">
<li class="ff-radio-li"><span class="ff-ext-radio-css ff-ext-selected" role="radio" aria-checked="true" aria-labelledby="lblCard_Processing_Agreement__c.Current_Visa_Or_MasterCard__c__1" tabindex="0"
name="Card_Processing_Agreement__c.Current_Visa_Or_MasterCard__c" id="Card_Processing_Agreement__c.Current_Visa_Or_MasterCard__c__1" data-value="Yes" data-ff-ext-radio-checked="true"></span><label
for="Card_Processing_Agreement__c.Current_Visa_Or_MasterCard__c__1" id="lblCard_Processing_Agreement__c.Current_Visa_Or_MasterCard__c__1">Yes</label></li>
<li class="ff-radio-li"><span class="ff-ext-radio-css" role="radio" aria-checked="false" aria-labelledby="lblCard_Processing_Agreement__c.Current_Visa_Or_MasterCard__c__2" tabindex="0"
name="Card_Processing_Agreement__c.Current_Visa_Or_MasterCard__c" id="Card_Processing_Agreement__c.Current_Visa_Or_MasterCard__c__2" data-value="No" data-ff-ext-radio-checked="false"></span><label
for="Card_Processing_Agreement__c.Current_Visa_Or_MasterCard__c__2" id="lblCard_Processing_Agreement__c.Current_Visa_Or_MasterCard__c__2">No</label></li>
</ul>
</div><select name="Card_Processing_Agreement__c.Current_Visa_Or_MasterCard__c" id="Card_Processing_Agreement__c.Current_Visa_Or_MasterCard__c" vatt="PICKLIST" class="ff-select-type ff-singlepicklist custom-select-offscreen"
data-flexcontrol="picklist-radiobutton-vertical" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="false" data-vatt="PICKLIST">
<option value="">--select an item--</option>
<option value="Yes" selected="selected">Yes </option>
<option value="No">No </option>
</select>
</div>
</div>
<div class="ff-item-row fw-row">
<div class="ff-col-1 ff-label-col"><label id="GENERALTEXT794" class="ff-label ff-general-text-label" vatt="STRING" data-ishidden="false">Section 2- Company Ownership Information</label></div>
</div>
<div class="ff-item-row fw-row">
<div class="ff-col-1 ff-label-col"><label id="GENERALTEXT646" class="ff-label ff-general-text-label" vatt="STRING" data-ishidden="false">Boost Payment Solutions partners with regulated financial services institutions and,
as such, we are required to obtain certain information to comply with Anti-Money Laundering (AML)/ Know Your Customer (KYC)/ Financial Crimes Reporting requirements via the Bank Secrecy Act, USA Patriot Act, and Financial
Crimes Enforcement Network (FINCEN) regulations. The information requested is dependent on your entity type. This information is not used for any purpose by Boost other than to meet federal regulations. Boost maintains
strict protocols for information and data security as well as confidentiality and privacy.</label></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Federal_Tax_ID__c" class="ff-label" id="lblCard_Processing_Agreement__cFederal_Tax_ID__c">Federal Tax ID</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Federal_Tax_ID__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Federal_Tax_ID__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="false" data-vatt="STRING"></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="TEXTAREA" for="Card_Processing_Agreement__c.Description_of_goods_or_service_provided__c" class="ff-label"
id="lblCard_Processing_Agreement__cDescription_of_goods_or_service_provided__c">Description of Goods or Services</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><textarea id="Card_Processing_Agreement__c.Description_of_goods_or_service_provided__c" placeholder="" aria-placeholder=""
name="Card_Processing_Agreement__c.Description_of_goods_or_service_provided__c" vatt="TEXTAREA" class="ff-textarea" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-ishtmlformatted="false" value=""
data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="false" data-vatt="TEXTAREA"></textarea></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="PICKLIST" for="Card_Processing_Agreement__c.Appropriate_Entity__c" class="ff-label" id="lblCard_Processing_Agreement__cAppropriate_Entity__c">Appropriate Entity</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><select name="Card_Processing_Agreement__c.Appropriate_Entity__c" id="Card_Processing_Agreement__c.Appropriate_Entity__c" vatt="PICKLIST" class="ff-select-type ff-singlepicklist" data-flexcontrol=""
data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="false" onchange="evaluateRules([1,7,8,9],this);" data-rules="1,7,8,9" data-vatt="PICKLIST">
<option value="" selected="selected">--select an item--</option>
<option value="Public Corporation">Public Corporation </option>
<option value="Private Corporation">Private Corporation </option>
<option value="Limited Liability Company">Limited Liability Company </option>
<option value="Sole Proprietor">Sole Proprietor </option>
<option value="Non-Profit">Non-Profit </option>
</select></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="PICKLIST" for="Card_Processing_Agreement__c.Beneficial_Owners_25_or_more__c" class="ff-label" id="lblCard_Processing_Agreement__cBeneficial_Owners_25_or_more__c">Does your business have
any beneficial owners with 25% or greater ownership?</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><select name="Card_Processing_Agreement__c.Beneficial_Owners_25_or_more__c" id="Card_Processing_Agreement__c.Beneficial_Owners_25_or_more__c" vatt="PICKLIST" class="ff-select-type ff-singlepicklist"
data-flexcontrol="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" onchange="evaluateRules([2,3,4,5,6],this);" data-rules="2,3,4,5,6" data-vatt="PICKLIST">
<option value="" selected="selected">--select an item--</option>
<option value="Yes">Yes </option>
<option value="No">No </option>
</select></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Name__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_1_or_Control_Manager_Name__c">Owner
Name</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Name__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Name__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Address__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_1_or_Control_Manager_Address__c">Owner
Address</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Address__c" placeholder="" aria-placeholder=""
name="Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Address__c" vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value=""
data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_1_City__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_1_City__c">Owner City</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_1_City__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_1_City__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_1_State__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_1_State__c">Owner State</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_1_State__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_1_State__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_1_Zip_Code__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_1_Zip_Code__c">Owner Zip Code/Postal Code</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_1_Zip_Code__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_1_Zip_Code__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="EMAIL" for="Card_Processing_Agreement__c.Owner_1_Email__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_1_Email__c">Owner Email</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_1_Email__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_1_Email__c" vatt="EMAIL"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 80 characters" maxlength="80" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="EMAIL"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="DATE" for="Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Date_of_Birth__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_1_or_Control_Manager_Date_of_Birth__c">Owner
Date of Birth</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Date_of_Birth__c" placeholder="" aria-placeholder=""
name="Card_Processing_Agreement__c.Owner_1_or_Control_Manager_Date_of_Birth__c" vatt="DATE" class="ff-input-type ff-type-text hasDatepicker" data-maxlengthmessage="Maximum 10 characters" maxlength="10" data-validatefieldtype="date"
value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="DATE"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_1_or_Control_Manager_SSN__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_1_or_Control_Manager_SSN__c">Owner Social Security
Number</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_1_or_Control_Manager_SSN__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_1_or_Control_Manager_SSN__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_1_Select_Ownership_Percentage__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_1_Select_Ownership_Percentage__c">Owner
Ownership Percentage</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_1_Select_Ownership_Percentage__c" placeholder="" aria-placeholder=""
name="Card_Processing_Agreement__c.Owner_1_Select_Ownership_Percentage__c" vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value=""
data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="PICKLIST" for="Card_Processing_Agreement__c.More_Beneficial_Owners_1__c" class="ff-label" id="lblCard_Processing_Agreement__cMore_Beneficial_Owners_1__c">Are there any other Beneficial
Owners with 25% or great ownership in the company?</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><select name="Card_Processing_Agreement__c.More_Beneficial_Owners_1__c" id="Card_Processing_Agreement__c.More_Beneficial_Owners_1__c" vatt="PICKLIST" class="ff-select-type ff-singlepicklist"
data-flexcontrol="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" onchange="evaluateRules([3,4,5,10],this);" data-rules="3,4,5,10" data-vatt="PICKLIST">
<option value="" selected="selected">--select an item--</option>
<option value="Yes">Yes </option>
<option value="No">No </option>
</select></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Name__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_2_or_Control_Manager_Name__c">Owner 2 -
Name</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Name__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Name__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Address__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_2_or_Control_Manager_Address__c">Owner 2 -
Address</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Address__c" placeholder="" aria-placeholder=""
name="Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Address__c" vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value=""
data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_2_City__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_2_City__c">Owner 2 City</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_2_City__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_2_City__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_2_State__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_2_State__c">Owner 2 State</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_2_State__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_2_State__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_2_Zip_Code__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_2_Zip_Code__c">Owner 2 Zip Code</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_2_Zip_Code__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_2_Zip_Code__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="EMAIL" for="Card_Processing_Agreement__c.Owner_2_Email__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_2_Email__c">Owner 2 Email</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_2_Email__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_2_Email__c" vatt="EMAIL"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 80 characters" maxlength="80" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="EMAIL"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="DATE" for="Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Date_of_Birth__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_2_or_Control_Manager_Date_of_Birth__c">Owner
2 - Date of Birth</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Date_of_Birth__c" placeholder="" aria-placeholder=""
name="Card_Processing_Agreement__c.Owner_2_or_Control_Manager_Date_of_Birth__c" vatt="DATE" class="ff-input-type ff-type-text hasDatepicker" data-maxlengthmessage="Maximum 10 characters" maxlength="10" data-validatefieldtype="date"
value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="DATE"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_2_or_Control_Manager_SSN__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_2_or_Control_Manager_SSN__c">Owner 2 - Social
Security Number</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_2_or_Control_Manager_SSN__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_2_or_Control_Manager_SSN__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_2_Select_Ownership_Percentage__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_2_Select_Ownership_Percentage__c">Owner 2 -
Ownership Percentage</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_2_Select_Ownership_Percentage__c" placeholder="" aria-placeholder=""
name="Card_Processing_Agreement__c.Owner_2_Select_Ownership_Percentage__c" vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value=""
data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="PICKLIST" for="Card_Processing_Agreement__c.More_Beneficial_Owners_2__c" class="ff-label" id="lblCard_Processing_Agreement__cMore_Beneficial_Owners_2__c">Are there any other Beneficial
Owners with 25% or great ownership in the company?</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><select name="Card_Processing_Agreement__c.More_Beneficial_Owners_2__c" id="Card_Processing_Agreement__c.More_Beneficial_Owners_2__c" vatt="PICKLIST" class="ff-select-type ff-singlepicklist"
data-flexcontrol="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" onchange="evaluateRules([4,5,10],this);" data-rules="4,5,10" data-vatt="PICKLIST">
<option value="" selected="selected">--select an item--</option>
<option value="Yes">Yes </option>
<option value="No">No </option>
</select></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Name__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_3_or_Control_Manager_Name__c">Owner 3 -
Name</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Name__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Name__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Address__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_3_or_Control_Manager_Address__c">Owner 3 -
Address</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Address__c" placeholder="" aria-placeholder=""
name="Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Address__c" vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value=""
data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_3_City__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_3_City__c">Owner 3 City</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_3_City__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_3_City__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_3_State__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_3_State__c">Owner 3 State</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_3_State__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_3_State__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_3_Zip_Code__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_3_Zip_Code__c">Owner 3 Zip Code</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_3_Zip_Code__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_3_Zip_Code__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="EMAIL" for="Card_Processing_Agreement__c.Owner_3_Email__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_3_Email__c">Owner 3 Email</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_3_Email__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_3_Email__c" vatt="EMAIL"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 80 characters" maxlength="80" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="EMAIL"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="DATE" for="Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Date_of_Birth__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_3_or_Control_Manager_Date_of_Birth__c">Owner
3 - Date of Birth</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Date_of_Birth__c" placeholder="" aria-placeholder=""
name="Card_Processing_Agreement__c.Owner_3_or_Control_Manager_Date_of_Birth__c" vatt="DATE" class="ff-input-type ff-type-text hasDatepicker" data-maxlengthmessage="Maximum 10 characters" maxlength="10" data-validatefieldtype="date"
value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="DATE"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_3_or_Control_Manager_SSN__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_3_or_Control_Manager_SSN__c">Owner 3 - Social
Security Number</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_3_or_Control_Manager_SSN__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_3_or_Control_Manager_SSN__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_3_Select_Ownership_Percentage__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_3_Select_Ownership_Percentage__c">Owner 3 -
Ownership Percentage</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_3_Select_Ownership_Percentage__c" placeholder="" aria-placeholder=""
name="Card_Processing_Agreement__c.Owner_3_Select_Ownership_Percentage__c" vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value=""
data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="PICKLIST" for="Card_Processing_Agreement__c.More_Beneficial_Owners_3__c" class="ff-label" id="lblCard_Processing_Agreement__cMore_Beneficial_Owners_3__c">Are there any other Beneficial
Owners with 25% or great ownership in the company?</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><select name="Card_Processing_Agreement__c.More_Beneficial_Owners_3__c" id="Card_Processing_Agreement__c.More_Beneficial_Owners_3__c" vatt="PICKLIST" class="ff-select-type ff-singlepicklist"
data-flexcontrol="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" onchange="evaluateRules([5,10],this);" data-rules="5,10" data-vatt="PICKLIST">
<option value="" selected="selected">--select an item--</option>
<option value="Yes">Yes </option>
<option value="No">No </option>
</select></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_4_Name__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_4_Name__c">Owner 4 Name</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_4_Name__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_4_Name__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_4_Address__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_4_Address__c">Owner 4 Address</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_4_Address__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_4_Address__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_4_City__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_4_City__c">Owner 4 City</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_4_City__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_4_City__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_4_State__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_4_State__c">Owner 4 State</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_4_State__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_4_State__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_4_Zip_Code__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_4_Zip_Code__c">Owner 4 Zip Code</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_4_Zip_Code__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_4_Zip_Code__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="EMAIL" for="Card_Processing_Agreement__c.Owner_4_Email__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_4_Email__c">Owner 4 Email</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_4_Email__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_4_Email__c" vatt="EMAIL"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 80 characters" maxlength="80" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="EMAIL"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="DATE" for="Card_Processing_Agreement__c.Owner_4_Date_of_Birth__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_4_Date_of_Birth__c">Owner 4 Date of Birth</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_4_Date_of_Birth__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_4_Date_of_Birth__c" vatt="DATE"
class="ff-input-type ff-type-text hasDatepicker" data-maxlengthmessage="Maximum 10 characters" maxlength="10" data-validatefieldtype="date" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="DATE"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Owner_4_Social_Security_Number__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_4_Social_Security_Number__c">Owner 4 Social Security
Number</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_4_Social_Security_Number__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_4_Social_Security_Number__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="DOUBLE(18,0)" for="Card_Processing_Agreement__c.Owner_4_Percentage_Ownership__c" class="ff-label" id="lblCard_Processing_Agreement__cOwner_4_Percentage_Ownership__c">Owner 4 Percentage
Ownership</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Owner_4_Percentage_Ownership__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Owner_4_Percentage_Ownership__c"
vatt="DOUBLE(18,0)" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 19 characters" maxlength="19" value="" data-flexcontrol="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="DOUBLE(18,0)"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Controlling_Manager_Executive_Name__c" class="ff-label" id="lblCard_Processing_Agreement__cControlling_Manager_Executive_Name__c">Control Person
Name</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Controlling_Manager_Executive_Name__c" placeholder="" aria-placeholder=""
name="Card_Processing_Agreement__c.Controlling_Manager_Executive_Name__c" vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value=""
data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Controlling_Manager_Executive_Address__c" class="ff-label" id="lblCard_Processing_Agreement__cControlling_Manager_Executive_Address__c">Control
Person Address</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Controlling_Manager_Executive_Address__c" placeholder="" aria-placeholder=""
name="Card_Processing_Agreement__c.Controlling_Manager_Executive_Address__c" vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value=""
data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Control_Person_City__c" class="ff-label" id="lblCard_Processing_Agreement__cControl_Person_City__c">Control Person City</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Control_Person_City__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Control_Person_City__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Control_Person_State__c" class="ff-label" id="lblCard_Processing_Agreement__cControl_Person_State__c">Control Person State</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Control_Person_State__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Control_Person_State__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Control_Person_Zip_Code_Postal_Code__c" class="ff-label" id="lblCard_Processing_Agreement__cControl_Person_Zip_Code_Postal_Code__c">Control Person
Zip Code/Postal Code</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Control_Person_Zip_Code_Postal_Code__c" placeholder="" aria-placeholder=""
name="Card_Processing_Agreement__c.Control_Person_Zip_Code_Postal_Code__c" vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value=""
data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Control_Person_Email__c" class="ff-label" id="lblCard_Processing_Agreement__cControl_Person_Email__c">Control Person Email</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Control_Person_Email__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Control_Person_Email__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="DATE" for="Card_Processing_Agreement__c.Controlling_Manager_Executive_DOB__c" class="ff-label" id="lblCard_Processing_Agreement__cControlling_Manager_Executive_DOB__c">Control Person Date
of Birth</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Controlling_Manager_Executive_DOB__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Controlling_Manager_Executive_DOB__c"
vatt="DATE" class="ff-input-type ff-type-text hasDatepicker" data-maxlengthmessage="Maximum 10 characters" maxlength="10" data-validatefieldtype="date" value="" data-requiredmessage="required" data-isrequired="true"
aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="DATE"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Controlling_Manager_Executive_SSN__c" class="ff-label" id="lblCard_Processing_Agreement__cControlling_Manager_Executive_SSN__c">Control Person
Social Security Number</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Controlling_Manager_Executive_SSN__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Controlling_Manager_Executive_SSN__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="DOUBLE(16,2)" for="Card_Processing_Agreement__c.Control_Person_Percentage_Owernship__c" class="ff-label" id="lblCard_Processing_Agreement__cControl_Person_Percentage_Owernship__c">Control
Person Percentage Ownernship</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Control_Person_Percentage_Owernship__c" placeholder="" aria-placeholder=""
name="Card_Processing_Agreement__c.Control_Person_Percentage_Owernship__c" vatt="DOUBLE(16,2)" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 19 characters" maxlength="19" value="" data-flexcontrol=""
data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="DOUBLE(16,2)"></div>
</div>
<div class="ff-item-row" title="File Upload" style="display: none;">
<div class="ff-col-1 ff-label-col"><label id="lblFileUpload580" for="FileUpload580" lblname="File Upload" class="ff-label ff-fileupload-label grayLabel">Upload IRS issued document including Federal Tax ID. Acceptable forms include SS-4,
147c or W-9.</label><span class="ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col">
<div class="ff-fileupload-drop-area" data-isnativeoptionselected="false" data-isrequired="true" data-maxfiles="3" data-maxfilesize="5" data-requiredmessage="required" data-uploadtochatter="false" data-uploadtosffile="true"
id="FileUploadArea580" name="FileUploadArea580" vatt="FILEUPLOAD" data-ishidden="true" data-filename="" data-attachto="1" data-allowedfiletypes="" data-uploadtointegration="false" data-fileserviceon="true" role="group"
aria-labelledby="lblFileUpload580" tabindex="-1" data-vatt="FILEUPLOAD">
<label class="ff-fileupload-select" for="FileUpload580" id="lblFileUpload580_Select" name="FileUpload580_Select" role="button" tabindex="0">Add File...</label>
<input class="ff-type-file" id="FileUpload580" name="FileUpload580" style="filter:alpha(opacity: 0);position: absolute;top: 0;left: -99999px;" type="file" tabindex="-1">
</div>
</div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="PICKLIST" for="Card_Processing_Agreement__c.Type_of_Nonprofit__c" class="ff-label" id="lblCard_Processing_Agreement__cType_of_Nonprofit__c">Type of Nonprofit</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><select name="Card_Processing_Agreement__c.Type_of_Nonprofit__c" id="Card_Processing_Agreement__c.Type_of_Nonprofit__c" vatt="PICKLIST" class="ff-select-type ff-singlepicklist" data-flexcontrol=""
data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="PICKLIST">
<option value="" selected="selected">--select an item--</option>
<option value="Nonprofit Corporation">Nonprofit Corporation </option>
<option value="Nonprofit Association">Nonprofit Association </option>
</select></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="PICKLIST" for="Card_Processing_Agreement__c.Region_where_services_are_performed__c" class="ff-label" id="lblCard_Processing_Agreement__cRegion_where_services_are_performed__c">Region where
services are performed</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><select name="Card_Processing_Agreement__c.Region_where_services_are_performed__c" id="Card_Processing_Agreement__c.Region_where_services_are_performed__c" vatt="PICKLIST"
class="ff-select-type ff-singlepicklist" data-flexcontrol="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="PICKLIST">
<option value="" selected="selected">--select an item--</option>
<option value="Domestic (US)">Domestic (US) </option>
<option value="International (non-US)">International (non-US) </option>
<option value="Both">Both </option>
</select></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Principal_Control_Person_Name__c" class="ff-label" id="lblCard_Processing_Agreement__cPrincipal_Control_Person_Name__c">Principal/Control Person
Name</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Principal_Control_Person_Name__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Principal_Control_Person_Name__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Principal_Control_Person_Address__c" class="ff-label" id="lblCard_Processing_Agreement__cPrincipal_Control_Person_Address__c">Principal/Control
Person Address</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Principal_Control_Person_Address__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Principal_Control_Person_Address__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Principal_Control_Person_City__c" class="ff-label" id="lblCard_Processing_Agreement__cPrincipal_Control_Person_City__c">Principal/Control Person
City</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Principal_Control_Person_City__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Principal_Control_Person_City__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Principal_Control_Person_State__c" class="ff-label" id="lblCard_Processing_Agreement__cPrincipal_Control_Person_State__c">Principal/Control Person
State</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Principal_Control_Person_State__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Principal_Control_Person_State__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Principal_Control_Person_Zip_Code__c" class="ff-label" id="lblCard_Processing_Agreement__cPrincipal_Control_Person_Zip_Code__c">Principal/Control
Person Zip Code/Postal Code</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Principal_Control_Person_Zip_Code__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Principal_Control_Person_Zip_Code__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Principal_Control_Person_Email__c" class="ff-label" id="lblCard_Processing_Agreement__cPrincipal_Control_Person_Email__c">Principal/Control Person
Email</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Principal_Control_Person_Email__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Principal_Control_Person_Email__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Principal_Control_Person_Phone__c" class="ff-label" id="lblCard_Processing_Agreement__cPrincipal_Control_Person_Phone__c">Principal/Control Person
Phone</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Principal_Control_Person_Phone__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Principal_Control_Person_Phone__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="DATE" for="Card_Processing_Agreement__c.Principal_Control_Person_Date_of_Birth__c" class="ff-label"
id="lblCard_Processing_Agreement__cPrincipal_Control_Person_Date_of_Birth__c">Principal/Control Person Date of Birth</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Principal_Control_Person_Date_of_Birth__c" placeholder="" aria-placeholder=""
name="Card_Processing_Agreement__c.Principal_Control_Person_Date_of_Birth__c" vatt="DATE" class="ff-input-type ff-type-text hasDatepicker" data-maxlengthmessage="Maximum 10 characters" maxlength="10" data-validatefieldtype="date"
value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="DATE"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Principal_Control_Person_Social_Security__c" class="ff-label"
id="lblCard_Processing_Agreement__cPrincipal_Control_Person_Social_Security__c">Principal/Control Person Social Security Number</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Principal_Control_Person_Social_Security__c" placeholder="" aria-placeholder=""
name="Card_Processing_Agreement__c.Principal_Control_Person_Social_Security__c" vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value=""
data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Stock_Exchange_Ticker_Symbola__c" class="ff-label" id="lblCard_Processing_Agreement__cStock_Exchange_Ticker_Symbola__c">Stock Exchange Ticker
Symbol</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Stock_Exchange_Ticker_Symbola__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Stock_Exchange_Ticker_Symbola__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Authorized_Signatory_Name__c" class="ff-label" id="lblCard_Processing_Agreement__cAuthorized_Signatory_Name__c">Authorized Signatory
Name</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Authorized_Signatory_Name__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Authorized_Signatory_Name__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Authorized_Signatory_Address__c" class="ff-label" id="lblCard_Processing_Agreement__cAuthorized_Signatory_Address__c">Authorized Signatory
Address</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Authorized_Signatory_Address__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Authorized_Signatory_Address__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Authorized_Signatory_City__c" class="ff-label" id="lblCard_Processing_Agreement__cAuthorized_Signatory_City__c">Authorized Signatory
City</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Authorized_Signatory_City__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Authorized_Signatory_City__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Authorized_Signatory_State__c" class="ff-label" id="lblCard_Processing_Agreement__cAuthorized_Signatory_State__c">Authorized Signatory
State</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Authorized_Signatory_State__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Authorized_Signatory_State__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Authorized_Signatory_Zip_Code__c" class="ff-label" id="lblCard_Processing_Agreement__cAuthorized_Signatory_Zip_Code__c">Authorized Signatory Zip
Code</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Authorized_Signatory_Zip_Code__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Authorized_Signatory_Zip_Code__c"
vatt="STRING" class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Authorized_Signatory_Email__c" class="ff-label" id="lblCard_Processing_Agreement__cAuthorized_Signatory_Email__c">Authorized Signatory
Email</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Authorized_Signatory_Email__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Authorized_Signatory_Email__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Authorized_Signatory_Phone__c" class="ff-label" id="lblCard_Processing_Agreement__cAuthorized_Signatory_Phone__c">Authorized Signatory
Phone</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Authorized_Signatory_Phone__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Authorized_Signatory_Phone__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Authorized_Signatory_Title__c" class="ff-label" id="lblCard_Processing_Agreement__cAuthorized_Signatory_Title__c">Authorized Signatory
Title</label><span class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Authorized_Signatory_Title__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Authorized_Signatory_Title__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="true" data-vatt="STRING"></div>
</div>
<div class="ff-item-row fw-row">
<div class="ff-col-1 ff-label-col"><label id="GENERALTEXT516" class="ff-label ff-general-text-label" vatt="STRING" data-ishidden="false">Section 3- Remittance Information</label></div>
</div>
<div class="ff-item-row fw-row">
<div class="ff-col-1 ff-label-col"><label id="GENERALTEXT82" class="ff-label ff-general-text-label" vatt="STRING" data-ishidden="false">Boost will need either a voided check or a bank letter on bank letterhead that provides the bank
account details for funding so we can deposit the funds into your preferred bank account. This is required to meet Anti-Money Laundering (AML)/ Know Your Customer (KYC)/ Financial Crimes Reporting Network (FINCEN)
regulations.</label></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Remittance_Contact__c" class="ff-label" id="lblCard_Processing_Agreement__cRemittance_Contact__c">Remittance Contact Name</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Remittance_Contact__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Remittance_Contact__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="false" data-vatt="STRING"></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="EMAIL" for="Card_Processing_Agreement__c.Remittance_Email__c" class="ff-label" id="lblCard_Processing_Agreement__cRemittance_Email__c">Remittance Contact Email</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Remittance_Email__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Remittance_Email__c" vatt="EMAIL"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 80 characters" maxlength="80" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="false" data-vatt="EMAIL"></div>
</div>
<div class="ff-item-row" title="File Upload">
<div class="ff-col-1 ff-label-col"><label id="lblFileUpload10" for="FileUpload10" lblname="File Upload" class="ff-label ff-fileupload-label">Upload voided blank check or banking information on bank letterhead.</label><span
class="ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col">
<div class="ff-fileupload-drop-area" data-isnativeoptionselected="false" data-isrequired="true" data-maxfiles="3" data-maxfilesize="5" data-requiredmessage="required" data-uploadtochatter="false" data-uploadtosffile="false"
id="FileUploadArea10" name="FileUploadArea10" vatt="FILEUPLOAD" data-ishidden="false" data-filename="" data-attachto="1" data-allowedfiletypes="" data-uploadtointegration="false" data-fileserviceon="true" role="group"
aria-labelledby="lblFileUpload10" tabindex="-1" data-vatt="FILEUPLOAD">
<label class="ff-fileupload-select" for="FileUpload10" id="lblFileUpload10_Select" name="FileUpload10_Select" role="button" tabindex="0">Add File...</label>
<input class="ff-type-file" id="FileUpload10" name="FileUpload10" style="filter:alpha(opacity: 0);position: absolute;top: 0;left: -99999px;" type="file" tabindex="-1">
</div>
</div>
</div>
<div class="ff-item-row fw-row">
<div class="ff-col-1 ff-label-col"><label id="GENERALTEXT87" class="ff-label ff-general-text-label" vatt="STRING" data-ishidden="false">Section 4- Authorization </label></div>
</div>
<div class="ff-item-row fw-row">
<div class="ff-col-1 ff-label-col"><label id="GENERALTEXT466" class="ff-label ff-general-text-label" vatt="STRING" data-ishidden="false">This form should be completed by someone who is authorized to sign on behalf of the company. Please
complete the following information for the authorized signatory.</label></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Authorized_Signatory__c" class="ff-label" id="lblCard_Processing_Agreement__cAuthorized_Signatory__c">Authorized Signatory Name</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Authorized_Signatory__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Authorized_Signatory__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="false" data-vatt="STRING"></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Job_Title_CPA__c" class="ff-label" id="lblCard_Processing_Agreement__cJob_Title_CPA__c">Authorized Signatory Title</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Job_Title_CPA__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Job_Title_CPA__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false"
data-ishidden="false" data-vatt="STRING"></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="EMAIL" for="Card_Processing_Agreement__c.Email_CPA__c" class="ff-label" id="lblCard_Processing_Agreement__cEmail_CPA__c">Authorized Signatory Email</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Email_CPA__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Email_CPA__c" vatt="EMAIL" class="ff-input-type ff-type-text"
data-maxlengthmessage="Maximum 80 characters" maxlength="80" data-validatefieldtype="" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true" data-isupsert="false" data-ishidden="false"
data-vatt="EMAIL"></div>
</div>
<div class="ff-item-row fw-row">
<div class="ff-col-1 ff-label-col"><label id="GENERALTEXT97" class="ff-label ff-general-text-label" vatt="STRING" data-ishidden="false">This application will not be processed unless and until all required information is provided
including beneficial ownership (Pursuant to FinCEN Federal Regulation 31 CFR Parts 1020, 1021, 1031 et. al.) and Supplier's voided check(s) or bank letter(s) are submitted. </label></div>
</div>
<div class="ff-item-row fw-row">
<div class="ff-col-1 ff-label-col"><label id="GENERALTEXT940" class="ff-label ff-general-text-label" vatt="STRING" data-ishidden="false">Terms and Conditions</label></div>
</div>
<div class="ff-item-row fw-row">
<div class="ff-col-1 ff-label-col"><label id="GENERALTEXT650" class="ff-label ff-general-text-label" vatt="STRING" data-ishidden="false">
<p style="padding: 0; margin: 0">This CARD PROCESSING APPLICATION AND AGREEMENT (“Agreement”) is made between and among You “Supplier” named below and BOOST PAYMENT SOLUTIONS, Inc. (“Boost”). Boost, as a registered Payment
Facilitator of Worldpay, LLC and its Sponsor Bank, Fifth Third Bank (collectively “Acquirer”), will provide Supplier with certain acquiring and payment processing services (“Services”) in accordance with the terms of this
Agreement. In consideration of Supplier’s receipt of credit or prepaid card payments, and participation in programs affiliated with Mastercard International Inc.® (“Mastercard”), Visa Inc. (“Visa”) or American Express (“Amex”),
Supplier is required to unconditionally comply with the Mastercard Operating Regulations, which are available at
<a style="color: #3079bb; text-decoration: none;" href="https://www.mastercard.us/en-us/about-mastercard/what-we-do/rules.html">www.mastercard.us/en-us/about-mastercard/what-we-do/rules.html</a>, the Visa Operating Regulations,
which are available at <a style="color: #3079bb; text-decoration: none;" download="">https://usa.visa.com/dam/VCOM/download/about-visa/visa-rules-public.pdf</a> and the Amex Operating Regulations, which are available at
<a style="color: #3079bb; text-decoration: none;" href="https://www209.americanexpress.com/merchant/services/en_US/merchant-regulations">https://www209.americanexpress.com/merchant/services/en_US/merchant-regulations</a>,
(collectively “Operating Regulations”). In the event that more than $1,000,000 in Visa transactions and/or $10,000,000 in Mastercard transactions (or such other amount provided by the Operating Regulations) (“Benchmark Amount”) is
processed through and on behalf of Supplier in any 12-month period, Supplier will automatically be deemed to have accepted, and will be bound by, the “Merchant Services Agreement for Sub-Merchants” with Acquirer which is set forth
at <a style="color: #3079bb; text-decoration: none;" href="https://www.boostb2b.com/boost-stp-additional-terms/">https://www.boostb2b.com/boost-stp-additional-terms/</a>, the terms of which will be independently enforceable by
Acquirer.<br><br>This Agreement is entered into, governed by, and construed pursuant to the laws of the State of New York without regard to conflicts of law provisions. Supplier agrees to comply with all applicable state, federal,
and local laws, rules, and regulations (“Laws”). Without limiting the foregoing, Supplier agrees that it will fully comply with any and all anti-money laundering laws and regulations, including but not limited to the Bank Secrecy
Act, the US Treasury’s Office of Foreign Assets Control (OFAC), the USA Patriot Act (or similar law, rule or regulation), and the Federal Trade Commission. Supplier shall be responsible for all chargebacks, fees, and related costs
or adjustments associated with the transactions submitted by Boost for processing on Supplier’s behalf and/or settled directly to Supplier’s depository account, and Boost shall have the absolute right to hold and/or debit
Supplier’s settlement funds or settlement account in the aggregate amount of each chargeback plus associated fees, costs and adjustments. Supplier agrees that any and all deposits will be deposited directly into the bank account
associated with the voided check or bank letter which Supplier provides pursuant to the Agreement. Unless other arrangements have been agreed to between Boost and Supplier, funds due Supplier will be settled to Supplier and
deposited net of the commercial card processing fees at the time of transaction. Supplier agrees that, in the event it has access to card data, it shall comply with the provisions of the Cardholder Information Security Program
(CISP) and PCI DSS. Boost may terminate this Agreement, at its sole discretion, and without notice, if (1) Supplier has failed to pay any amount owed to Boost when due, (2) Boost believes, in its sole discretion, that the
provision of Services to Supplier may be in violation of the Operating Regulations or the Laws, or (3) Boost believes, in its sole discretion, that Supplier has violated, or is likely to violate, the Operating Regulations or the
Laws. Notwithstanding the foregoing, the term of this agreement shall be for three years from the date hereof and shall automatically renew for consecutive twelve-month periods unless terminated by Boost pursuant to its
terminations rights herein. In addition, Supplier agrees that it will not: (1) knowingly submit any transactions that are illegal or that the Supplier should have known are illegal; (2) establish maximum transaction amounts unless
the Supplier is (i) a department, agency or instrumentality of, or owned or controlled by the U.S. Government or (ii) a college, university, business school or trade/vocational school; (3) submit a transaction on behalf of another
entity or submit a transaction that does not represent a payment between the Supplier and its customer; (4) submit a transaction to collect or finance an existing debt; (5) submit a transaction that represents the collection of a
previously dishonored check.<br><br>Supplier shall indemnify, defend and hold harmless Boost and its affiliates, including its employees, officers, directors, agents, and contractors (“Boost Indemnitees”), from and against any
fine, penalty, loss, cost, damage, injury, claim, action, expense, including reasonable attorneys’ fees, or other liabilities actually incurred by Boost Indemnitees which is not covered by insurance ("Liabilities"), arising from
or attributable in whole or in part to inaccurate, incomplete, inaccessible, tardy or unauthorized payment instructions or other data delivered by Supplier or its customer (cardholder) to Boost for the processing of transactions,
which inaccurate, incomplete, inaccessible, tardy or unauthorized information/data gives rise to a claim or loss by Supplier and/or such customer. This paragraph/indemnity shall survive the termination of this Agreement. Supplier
shall keep Boost Indemnitees fully informed of any such defense and afford Boost, at its own expense, an opportunity to participate in the defense or settlement of such Liabilities, and in no event shall Supplier agree to any
settlement of any claim asserted against any of Boost Indemnitees which has relief against any Boost Indemnitees without Boost Indemnitees’ knowledge and approval.<br><br>By signing where indicated below, Supplier and its
authorized signatory hereby represent, certify and acknowledge that 1) all information provided and all statements made in this Agreement are true, complete, and accurate; 2) Supplier’s authorized officer is authorized to enter
into this Agreement on behalf of Supplier; 3) Supplier agrees to accept card payments from those commercial customers that wish to pay via a commercial card utilizing Boost. Please notify Boost if you require different depository
and/or remittance notification information. 4) Supplier has accessed and read the Operating Regulations; and 5) the Operating Regulations are hereby incorporated into this Agreement by this reference.</p>
</label></div>
</div>
<div class="ff-item-row fw-row">
<div class="ff-col-1 ff-label-col"><label id="GENERALTEXT307" class="ff-label ff-general-text-label" vatt="STRING" data-ishidden="false">
<p> SUPPLIER HEREBY AGREES TO PAY APPLICABLE PUBLISHED INTERCHANGE RATES PLUS 0.54% AT THE TIME EACH TRANSACTION IS SETTLED.
<a href="https://www.boostb2b.com/booststprates/" style="color: #3079BB; text-decoration: underline" target="_blank">Click here to see the current Straight Through Processing rates for Mastercard and Visa transactions.</a>
</p>
</label></div>
</div>
<div class="ff-item-row fw-row">
<div class="ff-col-1 ff-label-col"><label id="GENERALTEXT783" class="ff-label ff-general-text-label" vatt="STRING" data-ishidden="false">Please check here to confirm that you have read and accept the Terms and Conditions of this
Agreement.</label></div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label id="lblFSGFRadioButton679" for="FSGFRadioButton679" class="ff-label" vatt="PICKLIST">I Agree</label><span class="ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col">
<div class="ff-select-to-radiobtn-list custom-flex-control-container">
<ul id="ulFSGFRadioButton679" class="ff-select-to-radiobtn-ul ff-ext-vertical" role="radiogroup" aria-labelledby="lblFSGFRadioButton679">
<li class="ff-radio-li"><span class="ff-ext-radio-css" role="radio" aria-checked="false" aria-labelledby="lblFSGFRadioButton679__1" tabindex="0" name="FSGFRadioButton679" id="FSGFRadioButton679__1" data-value="Yes"
data-ff-ext-radio-checked="false"></span><label for="FSGFRadioButton679__1" id="lblFSGFRadioButton679__1">Yes</label></li>
</ul>
</div><select id="FSGFRadioButton679" name="FSGFRadioButton679" vatt="PICKLIST" data-flexcontrol="picklist-radiobutton-vertical" class="ff-select-type ff-singlepicklist mainField custom-select-offscreen" data-ishidden="false"
data-isreadonly="false" data-isrequired="true" data-requiredmessage="required" data-vatt="PICKLIST">
<option value="" selected="selected">--select an item--</option>
<option value="Yes">Yes</option>
</select>
</div>
</div>
<div class="ff-item-row">
<div class="ff-col-1 ff-label-col"><label vatt="DATE" for="Card_Processing_Agreement__c.Sign_Date__c" class="ff-label" id="lblCard_Processing_Agreement__cSign_Date__c">Date Signed</label><span
class="requiredSpan ff-required-mark">*</span></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Sign_Date__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Sign_Date__c" vatt="DATE"
class="ff-input-type ff-type-text hasDatepicker" data-maxlengthmessage="Maximum 10 characters" maxlength="10" data-validatefieldtype="date" value="" data-requiredmessage="required" data-isrequired="true" aria-required="true"
data-isupsert="false" data-ishidden="false" data-vatt="DATE"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="TEXTAREA" for="Card_Processing_Agreement__c.Terms_and_Conditions_Submitted__c" class="ff-label" id="lblCard_Processing_Agreement__cTerms_and_Conditions_Submitted__c">Terms and Conditions
Submitted</label></div>
<div class="ff-col-2 ff-field-col"><textarea id="Card_Processing_Agreement__c.Terms_and_Conditions_Submitted__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Terms_and_Conditions_Submitted__c" vatt="TEXTAREA"
class="ff-textarea" data-maxlengthmessage="Maximum 131071 characters" maxlength="131071" data-ishtmlformatted="false"
value="This CARD PROCESSING APPLICATION AND AGREEMENT (“Agreement”) is made between and among You “Supplier” named below and BOOST PAYMENT SOLUTIONS, Inc. (“Boost”). Boost, as a registered Payment Facilitator of Worldpay, LLC and its Sponsor Bank, Fifth Third Bank (collectively “Acquirer”), will provide Supplier with certain acquiring and payment processing services (“Services”) in accordance with the terms of this Agreement. In consideration of Supplier’s receipt of credit or prepaid card payments, and participation in programs affiliated with Mastercard International Inc.® (“Mastercard”), Visa Inc. (“Visa”) or American Express (“Amex”), Supplier is required to unconditionally comply with the Mastercard Operating Regulations, which are available at www.mastercard.us/en-us/about-mastercard/what-we-do/rules.html, the Visa Operating Regulations, which are available at https://usa.visa.com/dam/VCOM/download/about-visa/visa-rules-public.pdf and the Amex Operating Regulations, which are available at https://www209.americanexpress.com/merchant/services/en_US/merchant-regulations, (collectively “Operating Regulations”). In the event that more than $1,000,000 in Visa transactions and/or $1,000,000 in Mastercard transactions (or such other amount provided by the Operating Regulations) (“Benchmark Amount”) is processed through and on behalf of Supplier in any 12-month period, Supplier will automatically be deemed to have accepted, and will be bound by, the “Merchant Services Agreement for Sub-Merchants” with Acquirer which is set forth at https://www.boostb2b.com/boost-stp-additional-terms/, the terms of which will be independently enforceable by Acquirer.
This Agreement is entered into, governed by, and construed pursuant to the laws of the State of New York without regard to conflicts of law provisions. Supplier agrees to comply with all applicable state, federal, and local laws, rules, and regulations (“Laws”). Without limiting the foregoing, Supplier agrees that it will fully comply with any and all anti-money laundering laws and regulations, including but not limited to the Bank Secrecy Act, the US Treasury’s Office of Foreign Assets Control (OFAC), the USA Patriot Act (or similar law, rule or regulation), and the Federal Trade Commission. Supplier shall be responsible for all chargebacks, fees, and related costs or adjustments associated with the transactions submitted by Boost for processing on Supplier’s behalf and/or settled directly to Supplier’s depository account, and Boost shall have the absolute right to hold and/or debit Supplier’s settlement funds or settlement account in the aggregate amount of each chargeback plus associated fees, costs and adjustments. Supplier agrees that any and all deposits will be deposited directly into the bank account associated with the voided check or bank letter which Supplier provides pursuant to the Agreement. Unless other arrangements have been agreed to between Boost and Supplier, funds due Supplier will be settled to Supplier and deposited net of the commercial card processing fees at the time of transaction. Supplier agrees that, in the event it has access to card data, it shall comply with the provisions of the Cardholder Information Security Program (CISP) and PCI DSS. Boost may terminate this Agreement, at its sole discretion, and without notice, if (1) Supplier has failed to pay any amount owed to Boost when due, (2) Boost believes, in its sole discretion, that the provision of Services to Supplier may be in violation of the Operating Regulations or the Laws, or (3) Boost believes, in its sole discretion, that Supplier has violated, or is likely to violate, the Operating Regulations or the Laws. Notwithstanding the foregoing, the term of this agreement shall be for three years from the date hereof and shall automatically renew for consecutive twelve-month periods unless terminated by Boost pursuant to its terminations rights herein. In addition, Supplier agrees that it will not: (1) knowingly submit any transactions that are illegal or that the Supplier should have known are illegal; (2) establish maximum transaction amounts unless the Supplier is (i) a department, agency or instrumentality of, or owned or controlled by the U.S. Government or (ii) a college, university, business school or trade/vocational school; (3) submit a transaction on behalf of another entity or submit a transaction that does not represent a payment between the Supplier and its customer; (4) submit a transaction to collect or finance an existing debt; (5) submit a transaction that represents the collection of a previously dishonored check.
Supplier shall indemnify, defend and hold harmless Boost and its affiliates, including its employees, officers, directors, agents, and contractors (“Boost Indemnitees”), from and against any fine, penalty, loss, cost, damage, injury, claim, action, expense, including reasonable attorneys’ fees, or other liabilities actually incurred by Boost Indemnitees which is not covered by insurance ("Liabilities"), arising from or attributable in whole or in part to inaccurate, incomplete, inaccessible, tardy or unauthorized payment instructions or other data delivered by Supplier or its customer (cardholder) to Boost for the processing of transactions, which inaccurate, incomplete, inaccessible, tardy or unauthorized information/data gives rise to a claim or loss by Supplier and/or such customer. This paragraph/indemnity shall survive the termination of this Agreement. Supplier shall keep Boost Indemnitees fully informed of any such defense and afford Boost, at its own expense, an opportunity to participate in the defense or settlement of such Liabilities, and in no event shall Supplier agree to any settlement of any claim asserted against any of Boost Indemnitees which has relief against any Boost Indemnitees without Boost Indemnitees’ knowledge and approval.
By signing where indicated below, Supplier and its authorized signatory hereby represent, certify and acknowledge that 1) all information provided and all statements made in this Agreement are true, complete, and accurate; 2) Supplier’s authorized officer is authorized to enter into this Agreement on behalf of Supplier; 3) Supplier agrees to accept card payments from those commercial customers that wish to pay via a commercial card utilizing Boost. Please notify Boost if you require different depository and/or remittance notification information. 4) Supplier has accessed and read the Operating Regulations; and 5) the Operating Regulations are hereby incorporated into this Agreement by this reference."
data-requiredmessage="required" data-isupsert="false" data-ishidden="true" readonly="readonly"
data-vatt="TEXTAREA">This CARD PROCESSING APPLICATION AND AGREEMENT (“Agreement”) is made between and among You “Supplier” named below and BOOST PAYMENT SOLUTIONS, Inc. (“Boost”). Boost, as a registered Payment Facilitator of Worldpay, LLC and its Sponsor Bank, Fifth Third Bank (collectively “Acquirer”), will provide Supplier with certain acquiring and payment processing services (“Services”) in accordance with the terms of this Agreement. In consideration of Supplier’s receipt of credit or prepaid card payments, and participation in programs affiliated with Mastercard International Inc.® (“Mastercard”), Visa Inc. (“Visa”) or American Express (“Amex”), Supplier is required to unconditionally comply with the Mastercard Operating Regulations, which are available at www.mastercard.us/en-us/about-mastercard/what-we-do/rules.html, the Visa Operating Regulations, which are available at https://usa.visa.com/dam/VCOM/download/about-visa/visa-rules-public.pdf and the Amex Operating Regulations, which are available at https://www209.americanexpress.com/merchant/services/en_US/merchant-regulations, (collectively “Operating Regulations”). In the event that more than $1,000,000 in Visa transactions and/or $1,000,000 in Mastercard transactions (or such other amount provided by the Operating Regulations) (“Benchmark Amount”) is processed through and on behalf of Supplier in any 12-month period, Supplier will automatically be deemed to have accepted, and will be bound by, the “Merchant Services Agreement for Sub-Merchants” with Acquirer which is set forth at https://www.boostb2b.com/boost-stp-additional-terms/, the terms of which will be independently enforceable by Acquirer.
This Agreement is entered into, governed by, and construed pursuant to the laws of the State of New York without regard to conflicts of law provisions. Supplier agrees to comply with all applicable state, federal, and local laws, rules, and regulations (“Laws”). Without limiting the foregoing, Supplier agrees that it will fully comply with any and all anti-money laundering laws and regulations, including but not limited to the Bank Secrecy Act, the US Treasury’s Office of Foreign Assets Control (OFAC), the USA Patriot Act (or similar law, rule or regulation), and the Federal Trade Commission. Supplier shall be responsible for all chargebacks, fees, and related costs or adjustments associated with the transactions submitted by Boost for processing on Supplier’s behalf and/or settled directly to Supplier’s depository account, and Boost shall have the absolute right to hold and/or debit Supplier’s settlement funds or settlement account in the aggregate amount of each chargeback plus associated fees, costs and adjustments. Supplier agrees that any and all deposits will be deposited directly into the bank account associated with the voided check or bank letter which Supplier provides pursuant to the Agreement. Unless other arrangements have been agreed to between Boost and Supplier, funds due Supplier will be settled to Supplier and deposited net of the commercial card processing fees at the time of transaction. Supplier agrees that, in the event it has access to card data, it shall comply with the provisions of the Cardholder Information Security Program (CISP) and PCI DSS. Boost may terminate this Agreement, at its sole discretion, and without notice, if (1) Supplier has failed to pay any amount owed to Boost when due, (2) Boost believes, in its sole discretion, that the provision of Services to Supplier may be in violation of the Operating Regulations or the Laws, or (3) Boost believes, in its sole discretion, that Supplier has violated, or is likely to violate, the Operating Regulations or the Laws. Notwithstanding the foregoing, the term of this agreement shall be for three years from the date hereof and shall automatically renew for consecutive twelve-month periods unless terminated by Boost pursuant to its terminations rights herein. In addition, Supplier agrees that it will not: (1) knowingly submit any transactions that are illegal or that the Supplier should have known are illegal; (2) establish maximum transaction amounts unless the Supplier is (i) a department, agency or instrumentality of, or owned or controlled by the U.S. Government or (ii) a college, university, business school or trade/vocational school; (3) submit a transaction on behalf of another entity or submit a transaction that does not represent a payment between the Supplier and its customer; (4) submit a transaction to collect or finance an existing debt; (5) submit a transaction that represents the collection of a previously dishonored check.
Supplier shall indemnify, defend and hold harmless Boost and its affiliates, including its employees, officers, directors, agents, and contractors (“Boost Indemnitees”), from and against any fine, penalty, loss, cost, damage, injury, claim, action, expense, including reasonable attorneys’ fees, or other liabilities actually incurred by Boost Indemnitees which is not covered by insurance ("Liabilities"), arising from or attributable in whole or in part to inaccurate, incomplete, inaccessible, tardy or unauthorized payment instructions or other data delivered by Supplier or its customer (cardholder) to Boost for the processing of transactions, which inaccurate, incomplete, inaccessible, tardy or unauthorized information/data gives rise to a claim or loss by Supplier and/or such customer. This paragraph/indemnity shall survive the termination of this Agreement. Supplier shall keep Boost Indemnitees fully informed of any such defense and afford Boost, at its own expense, an opportunity to participate in the defense or settlement of such Liabilities, and in no event shall Supplier agree to any settlement of any claim asserted against any of Boost Indemnitees which has relief against any Boost Indemnitees without Boost Indemnitees’ knowledge and approval.
By signing where indicated below, Supplier and its authorized signatory hereby represent, certify and acknowledge that 1) all information provided and all statements made in this Agreement are true, complete, and accurate; 2) Supplier’s authorized officer is authorized to enter into this Agreement on behalf of Supplier; 3) Supplier agrees to accept card payments from those commercial customers that wish to pay via a commercial card utilizing Boost. Please notify Boost if you require different depository and/or remittance notification information. 4) Supplier has accessed and read the Operating Regulations; and 5) the Operating Regulations are hereby incorporated into this Agreement by this reference.</textarea>
</div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="TEXTAREA" for="Card_Processing_Agreement__c.Rate_Submitted__c" class="ff-label" id="lblCard_Processing_Agreement__cRate_Submitted__c">Rate Submitted</label></div>
<div class="ff-col-2 ff-field-col"><textarea id="Card_Processing_Agreement__c.Rate_Submitted__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Rate_Submitted__c" vatt="TEXTAREA" class="ff-textarea"
data-maxlengthmessage="Maximum 32768 characters" maxlength="32768" data-ishtmlformatted="false" value="SUPPLIER HEREBY AGREES TO PAY APPLICABLE PUBLISHED INTERCHANGE RATES PLUS 0.54% AT THE TIME EACH TRANSACTION IS SETTLED."
data-requiredmessage="required" data-isupsert="false" data-ishidden="true" readonly="readonly"
data-vatt="TEXTAREA">SUPPLIER HEREBY AGREES TO PAY APPLICABLE PUBLISHED INTERCHANGE RATES PLUS 0.54% AT THE TIME EACH TRANSACTION IS SETTLED.</textarea></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Formstack_ID__c" class="ff-label" id="lblCard_Processing_Agreement__cFormstack_ID__c">Formstack ID</label></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Formstack_ID__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Formstack_ID__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="CPA - WorldPay - 0.54% " data-requiredmessage="required" data-isupsert="false" data-ishidden="true"
readonly="readonly" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.Page_URL__c" class="ff-label" id="lblCard_Processing_Agreement__cPage_URL__c">Page URL</label></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.Page_URL__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.Page_URL__c" vatt="STRING" class="ff-input-type ff-type-text"
data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="" data-requiredmessage="required" data-isupsert="false" data-ishidden="true" readonly="readonly" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="STRING" for="Card_Processing_Agreement__c.SF_Campaign__c" class="ff-label" id="lblCard_Processing_Agreement__cSF_Campaign__c">SF Campaign</label></div>
<div class="ff-col-2 ff-field-col"><input type="textbox" id="Card_Processing_Agreement__c.SF_Campaign__c" placeholder="" aria-placeholder="" name="Card_Processing_Agreement__c.SF_Campaign__c" vatt="STRING"
class="ff-input-type ff-type-text" data-maxlengthmessage="Maximum 255 characters" maxlength="255" data-validatefieldtype="" value="Mastercard" data-requiredmessage="required" data-isupsert="false" data-ishidden="true"
readonly="readonly" data-vatt="STRING"></div>
</div>
<div class="ff-item-row" style="display: none;">
<div class="ff-col-1 ff-label-col"><label vatt="REFERENCE" for="inputCard_Processing_Agreement__c.RecordTypeId" class="ff-label" id="lblCard_Processing_Agreement__cRecordTypeId">Record Type</label></div>
<div class="ff-col-2 ff-field-col"><input type="hidden" id="Card_Processing_Agreement__c.RecordTypeId" vatt="REFERENCE" readonly="readonly" value="0123c000000V9sZAAS" data-vatt="REFERENCE"><input type="textbox"
id="inputCard_Processing_Agreement__c.RecordTypeId" title="Lookup" placeholder="New CPA" name="inputCard_Processing_Agreement__c.RecordTypeId" class="ff-input-type ff-type-text lookup-link ll-readonly" readonly="readonly"
vatt="REFERENCE" value="New CPA" data-lobj="RecordType" data-robj="Card_Processing_Agreement__c" data-display-format="" data-relationship-name="" data-requiredmessage="required" data-isupsert="false" data-ishidden="true"
data-vatt="REFERENCE"></div>
</div>
</div>
</div>
<div class="ff-footer-group">
<div class="ff-item-row ff-footer-row">
<div class="ff-submit-btn">
<div class="footnoteDiv"><span class="requiredSpan ff-footnote ff-required-mark">*</span><label class="ff-footnote-label ff-label">- required</label></div>
<div class="btnDiv"><input type="button" class="sectionHeader ff-btn-submit" id="btnsubmit" value="Submit Application" data-btnmessage="Thank you for your submission!"
data-btnurl="https://boostb2b.com/thank-you-card-processing-application-submitted/"></div>
</div>
</div>
</div>
</div>
<script>
if (!window.jQuery) {
console.log('External jQuery not found. Loading FS4SF jQuery.');
try {
$ = fs;
} catch (error) {
console.log(error)
};
try {
jQuery = fs;
} catch (error) {
console.log(error)
};
}
let pageInput = document.getElementById('Card_Processing_Agreement__c.Page_URL__c');
pageInput.value = parent.document.URL;
</script>
</div>
</div>
<iframe id="ffIframe" name="ffIframe" style="display:none"></iframe>
<div id="dialog">
</div>
<div id="paymentDialog" style="display:none;overflow:hidden;">
<iframe id="paymentDialogIFrame" style="width:100%;height:100%;margin:0px;padding:0px;border:0" scrolling="no"></iframe>
</div>
<div id="ffLookupDialog" style="overflow:hidden">
</div>
<input type="hidden" id="selectedId" value="">
</form>Text Content
* Buyers
* Suppliers
* Issuers
* Strategic Partners
* Solutions
* Boost Intercept
* Dynamic Boost
* Company
* About
* Our Team
* Newsroom
* Careers
* Get Started
Menu
* Buyers
* Suppliers
* Issuers
* Strategic Partners
* Solutions
* Boost Intercept
* Dynamic Boost
* Company
* About
* Our Team
* Newsroom
* Careers
* Get Started
* Buyers
* Suppliers
* Issuers
* Strategic Partners
* Solutions
* Boost Intercept
* Dynamic Boost
* Company
* About
* Our Team
* Newsroom
* Careers
* Get Started
Menu
* Buyers
* Suppliers
* Issuers
* Strategic Partners
* Solutions
* Boost Intercept
* Dynamic Boost
* Company
* About
* Our Team
* Newsroom
* Careers
* Get Started
BOOST CARD PROCESSING APPLICATION AND AGREEMENT
* - Required Field
- More information
Section 1- Company Contact Information
Legal Name Of Supplier*
DBA (required if different than Legal Name)
Physical Address*
City*
Country*
State*
Postal/ZIP Code*
Phone*
Website*
Does your business currently accept a commercial credit card for B2B payments (P
Card or Virtual card, not a consumer or corporate card)*
* Yes
* No
--select an item--Yes No
Section 2- Company Ownership Information
Boost Payment Solutions partners with regulated financial services
institutions and, as such, we are required to obtain certain information to
comply with Anti-Money Laundering (AML)/ Know Your Customer (KYC)/ Financial
Crimes Reporting requirements via the Bank Secrecy Act, USA Patriot Act, and
Financial Crimes Enforcement Network (FINCEN) regulations. The information
requested is dependent on your entity type. This information is not used for any
purpose by Boost other than to meet federal regulations. Boost maintains strict
protocols for information and data security as well as confidentiality and
privacy.
Federal Tax ID*
Description of Goods or Services*
Appropriate Entity*
--select an item--Public Corporation Private Corporation Limited Liability
Company Sole Proprietor Non-Profit
Does your business have any beneficial owners with 25% or greater ownership?*
--select an item--Yes No
Owner Name*
Owner Address*
Owner City*
Owner State*
Owner Zip Code/Postal Code*
Owner Email*
Owner Date of Birth*
Owner Social Security Number*
Owner Ownership Percentage*
Are there any other Beneficial Owners with 25% or great ownership in the
company?*
--select an item--Yes No
Owner 2 - Name*
Owner 2 - Address*
Owner 2 City*
Owner 2 State*
Owner 2 Zip Code*
Owner 2 Email*
Owner 2 - Date of Birth*
Owner 2 - Social Security Number*
Owner 2 - Ownership Percentage*
Are there any other Beneficial Owners with 25% or great ownership in the
company?*
--select an item--Yes No
Owner 3 - Name*
Owner 3 - Address*
Owner 3 City*
Owner 3 State*
Owner 3 Zip Code*
Owner 3 Email*
Owner 3 - Date of Birth*
Owner 3 - Social Security Number*
Owner 3 - Ownership Percentage*
Are there any other Beneficial Owners with 25% or great ownership in the
company?*
--select an item--Yes No
Owner 4 Name*
Owner 4 Address*
Owner 4 City*
Owner 4 State*
Owner 4 Zip Code*
Owner 4 Email*
Owner 4 Date of Birth*
Owner 4 Social Security Number*
Owner 4 Percentage Ownership*
Control Person Name*
Control Person Address*
Control Person City*
Control Person State*
Control Person Zip Code/Postal Code*
Control Person Email*
Control Person Date of Birth*
Control Person Social Security Number*
Control Person Percentage Ownernship*
Upload IRS issued document including Federal Tax ID. Acceptable forms include
SS-4, 147c or W-9.*
Add File...
Type of Nonprofit*
--select an item--Nonprofit Corporation Nonprofit Association
Region where services are performed*
--select an item--Domestic (US) International (non-US) Both
Principal/Control Person Name*
Principal/Control Person Address*
Principal/Control Person City*
Principal/Control Person State*
Principal/Control Person Zip Code/Postal Code*
Principal/Control Person Email*
Principal/Control Person Phone*
Principal/Control Person Date of Birth*
Principal/Control Person Social Security Number*
Stock Exchange Ticker Symbol*
Authorized Signatory Name*
Authorized Signatory Address*
Authorized Signatory City*
Authorized Signatory State*
Authorized Signatory Zip Code*
Authorized Signatory Email*
Authorized Signatory Phone*
Authorized Signatory Title*
Section 3- Remittance Information
Boost will need either a voided check or a bank letter on bank letterhead that
provides the bank account details for funding so we can deposit the funds into
your preferred bank account. This is required to meet Anti-Money Laundering
(AML)/ Know Your Customer (KYC)/ Financial Crimes Reporting Network (FINCEN)
regulations.
Remittance Contact Name*
Remittance Contact Email*
Upload voided blank check or banking information on bank letterhead.*
Add File...
Section 4- Authorization
This form should be completed by someone who is authorized to sign on behalf of
the company. Please complete the following information for the authorized
signatory.
Authorized Signatory Name*
Authorized Signatory Title*
Authorized Signatory Email*
This application will not be processed unless and until all required information
is provided including beneficial ownership (Pursuant to FinCEN Federal
Regulation 31 CFR Parts 1020, 1021, 1031 et. al.) and Supplier's voided check(s)
or bank letter(s) are submitted.
Terms and Conditions
This CARD PROCESSING APPLICATION AND AGREEMENT (“Agreement”) is made between and
among You “Supplier” named below and BOOST PAYMENT SOLUTIONS, Inc. (“Boost”).
Boost, as a registered Payment Facilitator of Worldpay, LLC and its Sponsor
Bank, Fifth Third Bank (collectively “Acquirer”), will provide Supplier with
certain acquiring and payment processing services (“Services”) in accordance
with the terms of this Agreement. In consideration of Supplier’s receipt of
credit or prepaid card payments, and participation in programs affiliated with
Mastercard International Inc.® (“Mastercard”), Visa Inc. (“Visa”) or American
Express (“Amex”), Supplier is required to unconditionally comply with the
Mastercard Operating Regulations, which are available at
www.mastercard.us/en-us/about-mastercard/what-we-do/rules.html, the Visa
Operating Regulations, which are available at
https://usa.visa.com/dam/VCOM/download/about-visa/visa-rules-public.pdf and the
Amex Operating Regulations, which are available at
https://www209.americanexpress.com/merchant/services/en_US/merchant-regulations,
(collectively “Operating Regulations”). In the event that more than $1,000,000
in Visa transactions and/or $10,000,000 in Mastercard transactions (or such
other amount provided by the Operating Regulations) (“Benchmark Amount”) is
processed through and on behalf of Supplier in any 12-month period, Supplier
will automatically be deemed to have accepted, and will be bound by, the
“Merchant Services Agreement for Sub-Merchants” with Acquirer which is set forth
at https://www.boostb2b.com/boost-stp-additional-terms/, the terms of which will
be independently enforceable by Acquirer.
This Agreement is entered into, governed by, and construed pursuant to the laws
of the State of New York without regard to conflicts of law provisions. Supplier
agrees to comply with all applicable state, federal, and local laws, rules, and
regulations (“Laws”). Without limiting the foregoing, Supplier agrees that it
will fully comply with any and all anti-money laundering laws and regulations,
including but not limited to the Bank Secrecy Act, the US Treasury’s Office of
Foreign Assets Control (OFAC), the USA Patriot Act (or similar law, rule or
regulation), and the Federal Trade Commission. Supplier shall be responsible for
all chargebacks, fees, and related costs or adjustments associated with the
transactions submitted by Boost for processing on Supplier’s behalf and/or
settled directly to Supplier’s depository account, and Boost shall have the
absolute right to hold and/or debit Supplier’s settlement funds or settlement
account in the aggregate amount of each chargeback plus associated fees, costs
and adjustments. Supplier agrees that any and all deposits will be deposited
directly into the bank account associated with the voided check or bank letter
which Supplier provides pursuant to the Agreement. Unless other arrangements
have been agreed to between Boost and Supplier, funds due Supplier will be
settled to Supplier and deposited net of the commercial card processing fees at
the time of transaction. Supplier agrees that, in the event it has access to
card data, it shall comply with the provisions of the Cardholder Information
Security Program (CISP) and PCI DSS. Boost may terminate this Agreement, at its
sole discretion, and without notice, if (1) Supplier has failed to pay any
amount owed to Boost when due, (2) Boost believes, in its sole discretion, that
the provision of Services to Supplier may be in violation of the Operating
Regulations or the Laws, or (3) Boost believes, in its sole discretion, that
Supplier has violated, or is likely to violate, the Operating Regulations or the
Laws. Notwithstanding the foregoing, the term of this agreement shall be for
three years from the date hereof and shall automatically renew for consecutive
twelve-month periods unless terminated by Boost pursuant to its terminations
rights herein. In addition, Supplier agrees that it will not: (1) knowingly
submit any transactions that are illegal or that the Supplier should have known
are illegal; (2) establish maximum transaction amounts unless the Supplier is
(i) a department, agency or instrumentality of, or owned or controlled by the
U.S. Government or (ii) a college, university, business school or
trade/vocational school; (3) submit a transaction on behalf of another entity or
submit a transaction that does not represent a payment between the Supplier and
its customer; (4) submit a transaction to collect or finance an existing debt;
(5) submit a transaction that represents the collection of a previously
dishonored check.
Supplier shall indemnify, defend and hold harmless Boost and its affiliates,
including its employees, officers, directors, agents, and contractors (“Boost
Indemnitees”), from and against any fine, penalty, loss, cost, damage, injury,
claim, action, expense, including reasonable attorneys’ fees, or other
liabilities actually incurred by Boost Indemnitees which is not covered by
insurance ("Liabilities"), arising from or attributable in whole or in part to
inaccurate, incomplete, inaccessible, tardy or unauthorized payment instructions
or other data delivered by Supplier or its customer (cardholder) to Boost for
the processing of transactions, which inaccurate, incomplete, inaccessible,
tardy or unauthorized information/data gives rise to a claim or loss by Supplier
and/or such customer. This paragraph/indemnity shall survive the termination of
this Agreement. Supplier shall keep Boost Indemnitees fully informed of any such
defense and afford Boost, at its own expense, an opportunity to participate in
the defense or settlement of such Liabilities, and in no event shall Supplier
agree to any settlement of any claim asserted against any of Boost Indemnitees
which has relief against any Boost Indemnitees without Boost Indemnitees’
knowledge and approval.
By signing where indicated below, Supplier and its authorized signatory hereby
represent, certify and acknowledge that 1) all information provided and all
statements made in this Agreement are true, complete, and accurate; 2)
Supplier’s authorized officer is authorized to enter into this Agreement on
behalf of Supplier; 3) Supplier agrees to accept card payments from those
commercial customers that wish to pay via a commercial card utilizing Boost.
Please notify Boost if you require different depository and/or remittance
notification information. 4) Supplier has accessed and read the Operating
Regulations; and 5) the Operating Regulations are hereby incorporated into this
Agreement by this reference.
SUPPLIER HEREBY AGREES TO PAY APPLICABLE PUBLISHED INTERCHANGE RATES PLUS 0.54%
AT THE TIME EACH TRANSACTION IS SETTLED. Click here to see the current Straight
Through Processing rates for Mastercard and Visa transactions.
Please check here to confirm that you have read and accept the Terms and
Conditions of this Agreement.
I Agree*
* Yes
--select an item--Yes
Date Signed*
Terms and Conditions Submitted
This CARD PROCESSING APPLICATION AND AGREEMENT (“Agreement”) is made between and
among You “Supplier” named below and BOOST PAYMENT SOLUTIONS, Inc. (“Boost”).
Boost, as a registered Payment Facilitator of Worldpay, LLC and its Sponsor
Bank, Fifth Third Bank (collectively “Acquirer”), will provide Supplier with
certain acquiring and payment processing services (“Services”) in accordance
with the terms of this Agreement. In consideration of Supplier’s receipt of
credit or prepaid card payments, and participation in programs affiliated with
Mastercard International Inc.® (“Mastercard”), Visa Inc. (“Visa”) or American
Express (“Amex”), Supplier is required to unconditionally comply with the
Mastercard Operating Regulations, which are available at
www.mastercard.us/en-us/about-mastercard/what-we-do/rules.html, the Visa
Operating Regulations, which are available at
https://usa.visa.com/dam/VCOM/download/about-visa/visa-rules-public.pdf and the
Amex Operating Regulations, which are available at
https://www209.americanexpress.com/merchant/services/en_US/merchant-regulations,
(collectively “Operating Regulations”). In the event that more than $1,000,000
in Visa transactions and/or $1,000,000 in Mastercard transactions (or such other
amount provided by the Operating Regulations) (“Benchmark Amount”) is processed
through and on behalf of Supplier in any 12-month period, Supplier will
automatically be deemed to have accepted, and will be bound by, the “Merchant
Services Agreement for Sub-Merchants” with Acquirer which is set forth at
https://www.boostb2b.com/boost-stp-additional-terms/, the terms of which will be
independently enforceable by Acquirer. This Agreement is entered into, governed
by, and construed pursuant to the laws of the State of New York without regard
to conflicts of law provisions. Supplier agrees to comply with all applicable
state, federal, and local laws, rules, and regulations (“Laws”). Without
limiting the foregoing, Supplier agrees that it will fully comply with any and
all anti-money laundering laws and regulations, including but not limited to the
Bank Secrecy Act, the US Treasury’s Office of Foreign Assets Control (OFAC), the
USA Patriot Act (or similar law, rule or regulation), and the Federal Trade
Commission. Supplier shall be responsible for all chargebacks, fees, and related
costs or adjustments associated with the transactions submitted by Boost for
processing on Supplier’s behalf and/or settled directly to Supplier’s depository
account, and Boost shall have the absolute right to hold and/or debit Supplier’s
settlement funds or settlement account in the aggregate amount of each
chargeback plus associated fees, costs and adjustments. Supplier agrees that any
and all deposits will be deposited directly into the bank account associated
with the voided check or bank letter which Supplier provides pursuant to the
Agreement. Unless other arrangements have been agreed to between Boost and
Supplier, funds due Supplier will be settled to Supplier and deposited net of
the commercial card processing fees at the time of transaction. Supplier agrees
that, in the event it has access to card data, it shall comply with the
provisions of the Cardholder Information Security Program (CISP) and PCI DSS.
Boost may terminate this Agreement, at its sole discretion, and without notice,
if (1) Supplier has failed to pay any amount owed to Boost when due, (2) Boost
believes, in its sole discretion, that the provision of Services to Supplier may
be in violation of the Operating Regulations or the Laws, or (3) Boost believes,
in its sole discretion, that Supplier has violated, or is likely to violate, the
Operating Regulations or the Laws. Notwithstanding the foregoing, the term of
this agreement shall be for three years from the date hereof and shall
automatically renew for consecutive twelve-month periods unless terminated by
Boost pursuant to its terminations rights herein. In addition, Supplier agrees
that it will not: (1) knowingly submit any transactions that are illegal or that
the Supplier should have known are illegal; (2) establish maximum transaction
amounts unless the Supplier is (i) a department, agency or instrumentality of,
or owned or controlled by the U.S. Government or (ii) a college, university,
business school or trade/vocational school; (3) submit a transaction on behalf
of another entity or submit a transaction that does not represent a payment
between the Supplier and its customer; (4) submit a transaction to collect or
finance an existing debt; (5) submit a transaction that represents the
collection of a previously dishonored check. Supplier shall indemnify, defend
and hold harmless Boost and its affiliates, including its employees, officers,
directors, agents, and contractors (“Boost Indemnitees”), from and against any
fine, penalty, loss, cost, damage, injury, claim, action, expense, including
reasonable attorneys’ fees, or other liabilities actually incurred by Boost
Indemnitees which is not covered by insurance ("Liabilities"), arising from or
attributable in whole or in part to inaccurate, incomplete, inaccessible, tardy
or unauthorized payment instructions or other data delivered by Supplier or its
customer (cardholder) to Boost for the processing of transactions, which
inaccurate, incomplete, inaccessible, tardy or unauthorized information/data
gives rise to a claim or loss by Supplier and/or such customer. This
paragraph/indemnity shall survive the termination of this Agreement. Supplier
shall keep Boost Indemnitees fully informed of any such defense and afford
Boost, at its own expense, an opportunity to participate in the defense or
settlement of such Liabilities, and in no event shall Supplier agree to any
settlement of any claim asserted against any of Boost Indemnitees which has
relief against any Boost Indemnitees without Boost Indemnitees’ knowledge and
approval. By signing where indicated below, Supplier and its authorized
signatory hereby represent, certify and acknowledge that 1) all information
provided and all statements made in this Agreement are true, complete, and
accurate; 2) Supplier’s authorized officer is authorized to enter into this
Agreement on behalf of Supplier; 3) Supplier agrees to accept card payments from
those commercial customers that wish to pay via a commercial card utilizing
Boost. Please notify Boost if you require different depository and/or remittance
notification information. 4) Supplier has accessed and read the Operating
Regulations; and 5) the Operating Regulations are hereby incorporated into this
Agreement by this reference.
Rate Submitted
SUPPLIER HEREBY AGREES TO PAY APPLICABLE PUBLISHED INTERCHANGE RATES PLUS 0.54%
AT THE TIME EACH TRANSACTION IS SETTLED.
Formstack ID
Page URL
SF Campaign
Record Type
*- required
HOME
BUYERS
SUPPLIERS
ISSUERS
STRATEGIC PARTNERS
BOOST INTERCEPT®
DYNAMIC BOOST℠
ABOUT
NEWSROOM
CAREERS
CONTACT US
PRIVACY POLICY
© COPYRIGHT BOOST PAYMENT SOLUTIONS, INC. 2023
BOOST PAYMENT SOLUTIONS, INC., IS A REGISTERED ISO AND PAYMENT FACILITATOR OF
FIFTH THIRD BANK, N.A., CINCINNATI, OH., A REGISTERED PAYMENT FACILITATOR OF
ELAVON, INC., AND A REGISTERED ISO OF AIB MERCHANT SERVICES, DUBLIN, IRELAND.
"B2B. IT'S IN OUR DNA", "BOOST", "BOOST PAYMENT SOLUTIONS", "DYNAMIC BOOST",
"BOOST INTERCEPT" AND "ACCEPTANCE ON YOUR TERMS" ARE REGISTERED TRADEMARKS OF
BOOST PAYMENT SOLUTIONS, INC.