E-Commerce Merchant Account Request

What is the URL for the website that will be associated with this E-commerce Merchant Account?

What is the name of the event/function for which this site is being created?

Who is the web page designer for this site?
Full name:

Email address:

Phone number:

Who will do accounting and reconciliation for this site?
Full name:

Email address:

Phone:

Are there any others who should be listed as contacts for this account?
Please include their names, email addresses and/or telephone numbers below:

What PTA should receive credit card transaction funds from this site?
Treasury Services will credit this PTA if the settlement report and cashier deposit form are not received wtihin 3 business days after settlement date.
IF THE DEPARTMENT CONSISTENTLY DELAYS SUBMITTING THE SETTLEMENT REPORT, THE AUTHORIZE.NET ACCOUNT MAY BE SUSPENDED.

What PTA should be charged for credit card transaction fees (charged monthly)?

What is the date of the conference or event?


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Procedure for preparing web merchant deposits