FIRST NATIONAL BANK OF OMAHA/TSYS MERCHANT SOLUTIONS -2014

Home Browse Search

201405 Merchant Application SBS Pass Through CONFIDENTIAL Brand/Model MULTIPASS Brand/Model Brand/Model Equipment Option 0 UR Equipment Option Equipment Option 4 Fee $ 0.00 Quantity 1 Total $ 0.00 Fee $ Quantity Total $ Fee $ Quantity Total $ Payment Option PUR Payment Option Payment Option N _ PUR_N 3 month purchase Software Vendor .. Payment Application Version CARD BRAND FEES The following fees will he passed through at Card Brand's rate: Interchange, Assessments, Visa Zero Floor Limit: $0.1039 per transaction without corresponding authorization, Visa Base II: $0.0023 per Visa transaction, Visa Exception Item Fee, Visa Network Acquirer Processing Fee, Visa International Acquirer Fee (including High Risk), Visa Partial Authorization Non - participation Fee, Visa International Service (including cash advance), Viso Misuse, Visa Debit Transaction Integrity, Visa Fixed Acquirer Network Fee, MasterCard Acquirer License Fee: 0.0075% of gross MasterCard SALES dollar volume, MasterCard Kilobyte Fee: $0.0014 per each settled MasterCard transaction, MasterCard NABU Fee: $0.0195 per each authorized MasterCard transaction (except collection and refund transac- tions which will be assessed this fee upon settlement), MasterCard CVC2 Transaction Fee: $0.0025 per each transaction that receives a CVC2 response value of "M" (match) or "N" (no match), MasterCard AVS Fee - Card Present: $0.005 on all transactions processed at Card Present merchant locations where AVS was per- formed, MasterCard AVS Fee - Card Not Present: $0.0075 on all transactions processed at Card Not Present merchant locations where AVS was performed, Master- Card Cross - Border U. S.: $0.004 per each dollar of transaction processed at a U.S. location on a non -U.S. issued card, MasterCard Cross - Border U.S.-PR: $0.004 per each dollar of transaction processed at a Puerto Rico location on a non -Puerto Rico issued card, MasterCard Cross - Border Non -U.S.: $0.008 per each dollar of trans- action processed in foreign currency at a non -U. S. location on a U.S. issued card, MasterCard Cross- Border Non - U.S. -PR: $0.008 per each dollar of transaction pro- cessed in foreign currency at a non -Puerto Rico location on a Puerto Rico issued card, MasterCard Processing integrity Fee - Card Present: $0.045 per each approved MasterCard authorization without a reversal request within 24 hours of the initial card - present authorization, MasterCard Processing Integrity Fee - Card Not Present: $0,045 per each approved MasterCard authorization without a reversal request within 72 hours ofthe initial card -not- present authorization, MasterCard Processing Integrity Fee - T &E: $0.045 per each approved MasterCard authorization without a reversal request within 20 days of the initial T &E authorization, MasterCard Processing integrity Fee> 120 Days: $0.045 per each approved MasterCard authorization without corresponding settled transaction or reversal within 120 days of the approved authorization, MasterCard interregional Account Status Inquiry: $0.03 per each $0 Account Status inquiry performed on a card not issued in the same country as the merchant's location, MasterCard Intraregional Account Status Inquiry: $0.025 per each $0 Account Status Inquiry performed on a card issued in the same country as the merchant's location, Discover International Processing Fee, Discover International Service Fee, Discover Data Usage Fee, Discover Network Authorization Fee, All Other Applicable Card Brand Fees, in accordance with the terms set out in the Terms and Conditions, transfer funds will be made to /from the account set forth in the enclosed voided check or bank letter, Standard Premium ❑ DDA SALES PROFESSIONAL VERIFICATION By the signature below, the Sales Professional verifies that that the information stated in this Agreement is correct to the best of his /hcrknowledge and is as represent- ed to him /her by MERCHANT. S ro slonal Signatu Sales Professional Name Printed: Bret Johnson Sales zatiom Application Date: Physical Site Inspection Conducted By Sales TS hunt Solutions 7/14/14 Professional F]Yes ❑ No Please attach voided check here. Merchant Initials: X TSYS Merchant Solutions, LLC is a registered agent of First National Bank ofOmaha, 1620 Dodge Street, Omaha, NE 68197 3 of4