location by ajizai


									Note that when we process your application, these additional locations will be associated with the same processing in

 Submitter's Email:
 Submitter's Phone:

                                 ‘Doing Business As’
Agency Location Code                                 Federal Tax Location Contact   Location POC Location POC
                     Division*     (DBA) Name (23
       (ALC)                                             ID       Person (POC)        Address        City
                                     char. limit)

*The "Division" groups deposits in CA$HLINK II. If you need the collection from a Merchant ID location to be deposited into a
ed with the same processing information found on your application. You must submit new applications for each processing optio

                                                                                                          Who is purchasing
              Location POC   Location POC   Location POC   Location POC          Description of
                                                                                                       products/services? (drop-
                  State           Zip          Phone          E-mail         products/services sold:

D location to be deposited into a separate "bucket", apart from the rest of the transactions under your Fifth Third "Chain" account, then provi
ons for each processing option (Terminals, Pay.gov, or Software/Other).

                                                                           Number of
             If "Combination"   Consumer Presentment   Projected Annual                  Largest Projected
                  Explain:          (drop-down)        Card Volume ($)                    Transaction ($)
                                                                            Per Year

hird "Chain" account, then provide a new Division number or type "New Deposit". If unsure, leave this blank and we will use our best judgme
e, leave this blank and we will use our best judgment to pick a Division for you. Otherwise, send an email to CardAcquiringService@fms.trea
an email to CardAcquiringService@fms.treas.gov if you have further questions.

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