Voyager Merchant Program Application & Agreement Checklist

Before submitting your completed Merchant Application (the “Merchant Application” or “Application”) please:

Page 2
Merchant Information.

Complete all sections. Note that your legal name is required in this section; brand or abbreviated names cannot be accepted. Select your transaction acceptance method in the checkboxes provided to expedite set-up.

Page 3
Taxpayer Identification Number and Certification.

Complete this section OR submit a W-9. It is not necessary to do both. Sole proprietorships should provide owner's social security number in this section if taxes for the business are reported under their social security number and not under the federal tax ID.

Automated Clearing House Authorization and Bank Account Information.

All payments are made electronically. Applications cannot be processed unless this section is completed as directed. Submit a voided check with your completed Application.

Principal Owner.

Complete as directed.

Page 4
Personal Guaranty.

If this program will be guaranteed by the Principal Owner sign the Personal Guaranty section as directed. Personal Guaranty is not required unless otherwise stated in underwriting (with the exception of Sole Proprietorship). Cosigner is not required unless otherwise stated in underwriting.

Pages 5-12
The Voyager Merchant Program Agreement (the “Agreement”).

Read the terms and conditions carefully and retain a copy for your records. Altering any information on the terms and conditions will make this Merchant Application & Agreement invalid.

Page 12
Authorization and Execution.

Sign and complete as directed. Failure to properly complete this section will delay processing of your Application.

Please return completed Merchant Applications, voided check, ACH forms, and W9s, if included, to U.S. Bank by email to newmerchantapplications@usbank.com, fax to 866.645.3676 or mail to U.S. Bank at U.S. Bank | Merchant Program | 12800 Foster Street | Overland Park, Kansas 66213-2623. U.S. Bank will send you an Information Collection Form to complete and return. Please complete the Information Collection Form upon receipt and return it and any other materials that may be requested as soon as possible to ensure a seamless approval process. Failure to timely complete and return the Information Collection Form and other required materials will delay the application approval process.

If you have questions about the Merchant Program, please call 800-987-6590 or email newmerchantapplications@usbank.com.

Merchant Information

Part 1 of 2
Company's Legal Name
Date Company Established
mm/dd/yyyy
Doing Busniess As (DBA), if any. Please list all DBAs.
One DBA per line
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Company Phone Number - Merchant Number
___-___-____
Company Fax Number
___-___-____
Federal Tax ID
Company Physical Address
PO Boxes are not acceptable
Company Mailing Address (if different from Physical Address)
PO Boxes are not acceptable

Merchant Information

Part 2 of 2
Card Program Contact Name
Merchant Customer Service Number (if different than Company Phone Number)
___-___-____
Email Address (to contact company/merchant regarding processing of this application)
Website Address
Additional Contact Name(s) and Contact Information (Optional)
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Description of Products and Services Offered
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Estimated Average Ticket or Invoice Amount
$
Whole numbers only. No commas or decimal places.
Estimated Monthly Sales Volume
$
Whole numbers only. No commas or decimal places.
Point of Service (POS) Type
OPIS Station/Rack ID
Affiliated Service Group
Is your company a certified Minority or Women Owned Business (MWOB)?

Yes

No

Does merchant conduct business in a foreign country?

Yes

No

If yes, list countries and nature of business conducted
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Transaction Method

Indicate your transaction method by checking the appropriate box(es) below:

Vehicle Class 1-6

Vehicle Class 7-8

MSA POS*

U.S. Bank Voyager Maintenance Solution®

*MSA POS means the U.S. Bank Multi Service Aviation® point of sale device

Taxpayer Identification Number and Certification

Please provide taxpayer information below OR submit a W-9. It is not necessary to do both.
Check box if submitting a W-9
Legal Business Name (as shown on your Income Tax Return)
Employee Identification Number
Social Security Number (only needed if the business legal name is the owner's legal name)
___-__-____
Business Name/Entity Name (if different from above)
Select Federal Tax Classification:

Individual/Sole Proprietor

C Corporation

S Corporation

Partnership

Trust/Estate

Other

Tax Exempt Organization (include documents that support tax status)

Limited Liability Company

If LLC, Select Tax Classification:

C Corporation

S Corporation

Partnership

Under penalties of perjury, and by its signature on this instrument, Merchant certifies that:
DO NOT check item 2 below if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.

1. The number shown on this Merchant Application is the correct taxpayer identification number (or I am waiting for a number to be issued to me), and

2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and

3. I am a U.S. citizen or other U.S. person. (See IRS instructions for form W-9 and/or form W-8BEN for information defining who is a U.S. person.)

Automated Clearing House

Merchant agrees that all settlement shall be made by Automated Clearing House (“ACH”) Payment. Accordingly, U.S. Bank National Association shall deposit funds into the bank account referenced below by ACH for payment of each daily billing file processed b y U.S. Bank. Merchant also agrees that each daily billing file, prior to being paid, will be adjusted with debit transactions to account for billing errors, chargebacks and/or fees and all other charges as stated in section 3 of the Agreement. U.S. Bank is authorized to make adjustments (debit transactions) to Merchant's accounts in the event of billing errors or chargebacks. Disputes regarding deposits (credits) should be made within 15 days of issuance of the daily billing file. Disputes regarding charges (debits) should be made within 45 days after the account was charged.

Complete all areas below and submit a voided check
Name of Bank
Branch
Bank Phone Number
___-___-____
City
State
Zip Code
Transit/ABA Number - Routing Number
Account Number
Account Settlement Contact and/or Individual(s) authorized to make changes to Bank information
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Printed Name
Title
Account Settlement Email Address

Principal Owner

First Name
Middle Initial
Last Name
Percentage of Ownership
%
Whole numbers only. No decimal places.
Title
Date of Birth
mm/dd/yyyy
Social Security Number
___-__-____
Home Address
PO Boxes are not acceptable
Email Address

Personal Guaranty

If this program will be guaranteed by the Principal Owner, fill out the section(s) as directed.

This section is NOT REQUIRED unless otherwise stated in underwriting (with the exception of Sole Proprietorship).

The undersigned Guarantor(s), by signing this Merchant Application, jointly and severally, guaranty the performance and payment by Merchant of its duties and obligations to U.S. Bank pursuant to this Merchant Application and the Agreement, as may be amended from time to time, with or without notice. Guarantor(s) understand further that U.S. Bank may proceed directly against Guarantor(s) without first exhausting U.S. Bank’s remedies against any other person or entity responsible to U.S. Bank or any security held by U.S. Bank or Merchant. This Personal Guaranty will not be discharged or affected by the death of the Guarantor(s), will bind all heirs, administrators, representatives and assigns and may be enforced by or for the benefit of any of U.S. Bank’s successors. Guarantor(s) understand that the inducement to U.S. Bank to accept this Merchant Application is consideration for the guaranty and that this Personal Guaranty remains in full force and effect even if the Guarantor(s) receive no additional benefit for this Personal Guaranty.

Printed Name
Social Security Number
___-__-____
Date
mm/dd/yyyy

Signature of Authorized Individual:

Hold mouse and drag to draw your signature

Cosigner

Printed Name
Social Security Number
___-__-____
Date
mm/dd/yyyy
Cosigner's Home Address
PO Boxes are not acceptable

Signature of Authorized Individual:

Hold mouse and drag to draw your signature

Terms and Agreement

Date
Merchant Name
Printed Name of Authorized Signer
Printed Title of Authorized Signer

Signature of Authorized Individual:

Hold mouse and drag to draw your signature
Electronic Signature Agreement
By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions.
I Accept