The following questions are designed to assess the possibility of your business being deleted from the MasterCard "MATCH" File ["Member Alert to Control High-Risk (Merchants)" File] or to provide related Merchant Account legal and consulting services. If you simply want to know if you have been placed on the MATCH File, do not use this form. Instead, please contact the bank, which terminated or declined your merchant account and inquire whether you are listed on the MATCH, including the reason & reason code for the listing.
This encrypted questionnaire is a far more effective tool than a telephone conference for communicating your concerns to this office. Therefore, please take the time to fully and completely respond to the questions below and submit your responses before attempting to contact this office by telephone. Your cooperation is appreciated.
* Required fields are in red.
Your E-mail Address:
Business Website Address(es) or Domain Name(s):
1.
Business Information:
Legal Business Name
Doing Business As
Business Address
City
State
Zip
Phone
Fax
2.
Legal Structure of Business:
3.
Owner(s) of Business:
First Name
Last Name
Address
City
State
Zip
Phone
Additional First Name(s)
Additional Last Name(s)
4.
In what State is your business registered?
5.
Contact Person with full authority to handle this matter for your business:
First Name
Last Name
Title
Address
City
State
Zip
Phone
Fax
Email
6.
Business Name (including any "doing business as" or "dba" names) and Address that appear on Merchant Application: (Leave blank if unknown)
Business Name
Address
City
State
Zip
7.
Personal Guarantor's Information: (Leave blank if unknown)
First Name
Last Name
Address
City
State
Zip
Phone
9.
Business Location:
10.
Specify Type of Business (i.e. Auto Parts Wholesaler, Cellular Phone Sales, Web Hosting & Design, Travel, Internet Auction site, Subscription or Membership, Leads Service, etc.):
11.
Specify Type of Product(s) sold or Service(s) provided:
How do you conduct your marketing?
12.
How long have you been in business?
13.
Monthly Processing Limit:
$
14.
Monthly Sales Volume:
$
15.
Average Ticket: (Dollar Amount or Range)
$
16.
Discount Rate for Processing Credit Card Transactions:
%
17.
Types of Credit Cards Accepted:
18.
Percentage of Sales from credit cards:
%
19.
Reserve Rate (%) or Amount Held ($):
% or $
20.
Merchant Bank or Service Provider that terminated your account, placed you on the MATCH File, or with whom you have a dispute:
Name of Institution
Representative First Name
Representative Last Name
Address
City
State
Zip
Phone
21.
When you opened your merchant account, what training or education did the bank or its agent provide you for processing transactions?
22.
When was your merchant account terminated or when did you experience your current account problems?
23.
Type of Problem:
24.
Do you have a copy of your merchant agreement?
25.
Were you given a copy of your merchant agreement?
26.
Do you have letters or other documents from the Bank indicating problems with your merchant account?
27.
How did you attempt to resolve your problem with the bank or service provider?
28.
With whom did you communicate:
First Name
Last Name
Address
City
State
Zip
Phone
Fax
Email
29.
If you are deleted from the MATCH, will you undergo merchant education to comply with all processing rules and requirements?
30.
If required, what security can you provide for a new merchant account?
31.
If you are not deleted from the MATCH will you go out-of-business?
32.
If you are deleted from the MATCH or resolve your merchant account problem, how much additional income will your business generate?
$/
33.
How did you learn about this website?
34.
Did you find this website helpful?
35.
Why or why not? Please explain:
Important Legal Notices:
NOTICE: STATUTE OF LIMITATIONS: THERE MAY BE STRICT TIME LIMITATIONS WITHIN WHICH YOU MUST FILE A LAWSUIT OR OTHERWISE ACT IN ORDER TO PROTECT YOUR RIGHTS. THESE TIME LIMITS ARE COMPLEX AND VARY BY JURISDICTION FOR DIFFERENT TYPES OF LEGAL ACTIONS. FAILURE TO FILE A LAWSUIT OR TAKE OTHER ACTION WITHIN THE REQUIRED TIME PERIOD COULD FOREVER BAR YOU FROM PURSUING YOUR CLAIM. IF YOU WISH TO PURSUE YOUR MATTER BY LAWSUIT, ADMINISTRATIVE LAW PROCEEDING, BINDING ARBITRATION OR BY ANY MEANS OTHER THAN INTENSIVE OUT-OF-COURT NEGOTIATION, YOU SHOULD IMMEDIATELY CONTACT ANOTHER ATTORNEY FOR ADVICE. By checking this box, I acknowledge that I have read and fully understand the above notice.
NOTICE: No Guarantee of Result: Please be informed that while MATCH removal or other positive results are possible in select cases, and while these services have been successfully performed for satisfied clients, this office cannot by law make any guarantee of results. Submission of this evaluation form does not create an Attorney-Client representation agreement. Any representation by this office will be strictly done by written agreement signed by both Attorney and Client. By checking this box, I acknowledge that I have read and fully understand the above notice.
NOTICE: Site Contents Are Not Legal Advice: The contents of this website are informative in nature and reflect the opinions of this office. You are by no means to rely upon or construe this website's information as legal advice. Laws, rules and trade practices change over time and therefore the accuracy of the information on this website cannot be guaranteed. By checking this box, I acknowledge that I have read and fully understand the above notice.
