Center Application

Tuition Express Merchant Transaction Processing Agreement
1 West Main, Ste. 201
Medford OR 97501
Phone: (888) 419-5033 Fax: 541-858-7008

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INSTRUCTIONS

Complete Application
Complete all sections of this Application that pertain to your business.

Submit & Finalize
Once complete, click the "Submit and Finalize Application" button.

Sign and Send Required Documentation
Sign Signature Page and send required documentation to Tuition Express.

Questions?
Call Tuition Express at: 1-888-419-5033

Required Documentation to Send

Once you submit your application online, Fax or Email the following to Tuition Express:

Voided Check or Bank Letter confirming your bank routing/account number
Printed and Signed Signature Page

Additional documentation may be requested as part of your application process:

Tax ID Number Verification – IRS Form SS-4 or IRS Document showing Legal Business Name and Tax ID Number

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BUSINESS PROFILE

OWNER / OFFICER INFORMATION
This form requires you to provide the name, address, date of birth and Social Security number (or passport number or other similar information, in the case of foreign persons) for each individual, if any, who owns, directly or indirectly, 25 percent or more of the equity interests of the legal entity customer (e.g., each natural person that owns 25 percent or more of the shares of a corporation); and an individual with significant responsibility for managing the legal entity customer (e.g., a Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, etc.).

How many individuals own, directly or indirectly, 25 percent or more of the equity interests in your company?

Select additional individuals:

Help

Primary Owner / Officer:
Full Name: Help		Title: Help	Social Security #: Help	% Ownership: Help
Residential Address: Help		City:	State:	Zip: Help
Phone Number: Help	How Long At This Address: Help	Date Of Birth:	Drivers License Number:	State Issued:
Passport # (non-US only): Help		Passport Country of Issue: Help		Use as person with significant managerial control Help

Second Owner / Officer:
Full Name: Help		Title: Help	Social Security #: Help	% Ownership: Help
Residential Address: Help		City:	State:	Zip: Help
Phone Number: Help	How Long At This Address: Help	Date Of Birth:	Drivers License Number:	State Issued:
Passport # (non-US only): Help		Passport Country of Issue: Help		Use as person with significant managerial control Help

Third Owner / Officer:
Full Name: Help		Title: Help	Social Security #: Help	% Ownership: Help
Residential Address: Help		City:	State:	Zip: Help
Phone Number: Help	How Long At This Address: Help	Date Of Birth:	Drivers License Number:	State Issued:
Passport # (non-US only): Help		Passport Country of Issue: Help		Use as person with significant managerial control Help

Fourth Owner / Officer:
Full Name: Help		Title: Help	Social Security #: Help	% Ownership: Help
Residential Address: Help		City:	State:	Zip: Help
Phone Number: Help	How Long At This Address: Help	Date Of Birth:	Drivers License Number:	State Issued:
Passport # (non-US only): Help		Passport Country of Issue: Help		Use as person with significant managerial control Help

Individual with Significant Managerial Control of Legal Entity:
Full Name: Help		Title: Help	Social Security #: Help	% Ownership: Help
Residential Address: Help		City:	State:	Zip: Help
Phone Number: Help	How Long At This Address: Help	Date Of Birth:	Drivers License Number:	State Issued:
Passport # (non-US only): Help		Passport Country of Issue: Help

Procare Software is a registered ISO of Wells Fargo Bank, N.A., Concord, CA

BANK INFORMATION
In accordance with the agreed to Terms & Conditions, all fund transfers will be made to/from the account set forth in the voided check attached to this application and referenced below.

Bank Name: Help	ABA Routing Number: Help	Account Number: Help	Account Type: Checking Savings
Bank Address: Help	City:	State:	Zip: Help

PAYMENT ASSUMPTIONS
The values you enter in this section are assumed by all parties to be estimates (i.e. an educated guess) and do not affect your rates in any way.

Credit Card Processing

ACH PROCESSING (debits from checking or savings accounts)

Requested Card Types:

Help

Average Monthly Credit Card Volume: Help

Average Monthly ACH Volume: Help

Average Single ACH Transaction: Help

Types Of Transactions (%) - Must Add Up to 100%

Batch Processing:

Average Single Credit Card Transaction: Help

Average Monthly ACH Count: Help

Highest Single ACH Transaction: Help

POS Swiped:

Help

Highest Single Credit Card Transaction: Help

ACH Entry Type: PPD/CCD
ACH Reclear: NO

SCHEDULE OF FEES

Visa, Mastercard, Discover and AMEX OptBlue Rates
Rate 1: 1.15% + $0.33 per item	Rate 5: 2.20% + $0.33 per item	Rate 9: 3.00% + $0.33 per item
Rate 2: 1.45% + $0.33 per item	Rate 6: 2.40% + $0.33 per item	Rate 10: 3.20% + $0.33 per item
Rate 3: 1.70% + $0.33 per item	Rate 7: 2.60% + $0.33 per item	Rate 11: 3.45% + $0.33 per item
Rate 4: 1.95% + $0.33 per item	Rate 8: 2.80% + $0.33 per item	Rate 12: 3.70% + $0.33 per item
Chargeback Fee: $25.00 each Retrieval Fee: $15.00 each
All other applicable Association fees will be passed through at the Association's rate. For more information, please contact Tuition Express.

ACH Fees:

Per Item Fee: $0.75 each

Return Item (RTN) Fee: $3.50 each

Notification Of Change (NOC) Fee: $3.50 each

Monthly Maintenance Fee:

$18.50 per location

Procare Software is a registered ISO of Wells Fargo Bank, N.A., Concord, CA

TUITION EXPRESS MERCHANT TRANSACTION PROCESSING AGREEMENT ACCEPTANCE

By their execution below the undersigned parties agree to abide by the Merchant Transaction Processing Agreement (the "AGREEMENT"). The AGREEMENT consists of the Merchant Application and the Terms and Conditions (a separate attachment hereto), and MERCHANT acknowledges it has received and read the Terms and Conditions at the time of signing. MERCHANT warrants that the information provided on the Merchant Application is complete and accurate. MERCHANT authorizes Tuition Express and/or BANK to provide a copy of this Merchant Application to any third party for the services requested. MERCHANT, its signing officer, owner, partner and any Personal Guarantor authorize Tuition Express, BANK or their agents or assigns, to make from time to time, business or personal credit inquiries and other inquiries in connection with this Merchant Application or the Agreement. By executing this Merchant Application, MERCHANT, its signing officer, owner, partner and any Personal Guarantor acknowledge that Tuition Express and/or BANK has a legitimate business need for the information contained in any personal credit report that may be obtained in connection with this Merchant Application or the Agreement, and that this Application is a business transaction that was initiated by the MERCHANT and/or any Personal Guarantor identified above. If applicable, MERCHANT agrees by its signature below to the TMS Discover Agreement and the American Express OptBlue Program Agreement. TMS is not a party to the Merchant Transaction Processing Agreement. BANK is not party to these agreements and has no obligation or liability under such agreements. In witness whereof the parties hereto have caused this AGREEMENT to be executed by their duly authorized representatives effective on the date signed or approved by BANK.

I have downloaded and read:

Signature Box: (Tuition Express Merchant Transaction Processing Agreement) To be signed on the signature page of this application: Help

MEMBER BANK DISCLOSURE

MEMBER BANK DISCLOSURE	IMPORTANT MEMBER BANK (ACQUIRER) RESPONSIBILITIES	IMPORTANT MERCHANT RESPONSIBLITIES
Procare Software 1 West Main St 201 Medford, OR 97501 (888) 419-5033 Wells Fargo Bank, N.A. PO Box 6079 Concord, CA 94524 (844) 284-6834	1. The Bank is the only entity approved to extend acceptance of Payment Network products directly to a Merchant. 2. The Bank must be a principal (signer) to the Merchant Agreement. 3. The Bank is responsible for educating Merchants of pertinent Visa and Mastercard rules with which Merchants must comply, but this information may be provided to you by the Processor. 4. The Bank is responsible for and must provide settlement funds to the Merchant. 5. The Bank is responsible for all funds held in reserve.	1. Ensure compliance with cardholder data security and storage requirements. 2. Maintain fraud and chargebacks below Payment Network thresholds. 3. Review and understand the terms of the Merchant Agreement. 4. Comply with Payment Network rules. 5. Retain a signed copy of this Disclosure Page. Merchant Resources • You may download “Visa Regulations” from Visa’s website at: https://usa.visa.com/support/consumer/visa-rules.html • You may download “Mastercard Rules” from Mastercard’s website at: https://www.mastercard.us/en-us/business/overview/support/rules.html
The responsibilities listed above do not replace the terms of the Merchant Agreement and are provided to ensure the Merchant understands some important obligations of each party and that the Bank is the ultimate authority should the Merchant experience any problems.
I have downloaded and read:
Signature Box: (Member Bank Disclosure) To be signed on the signature page of this application: Help

AMERICAN EXPRESS AGREEMENT ACCEPTANCE

By signing below, Merchant, Procare Software, and TSYS Merchant Solutions, LLC ("TMS") agree to the terms of the TMS American Express Agreement. TMS is not a party to the Merchant Transaction Processing Agreement.

Merchant agrees that Bank is not a party to any agreement for services from American Express, and that any such agreements are strictly between Merchant and American Express. Merchant must be approved by American Express and American Express may send its agreement to the address of Merchant indicated herein upon such approval. Merchant agrees to be bound by American Express' agreement. As it pertains to American Express, by signing the Merchant Transaction Processing Agreement, I represent that I have read and am authorized to sign and submit this application on behalf of Merchant and all information I have provided herein is true, complete, and accurate. I authorize American Express Travel Related Services Company, Inc. ("AXP") to verify the information in this application and receive and exchange information about me personally, including by requesting reports from consumer reporting agencies. I authorize and direct AXP to inform me directly, or through Merchant, of reports about me that AXP has requested from consumer reporting agencies. Such information will include the name and address of the agency furnishing the report. I also authorize AXP to use the reports from consumer reporting agencies for marketing and administrative purposes. I understand that upon AXP's approval of Merchant to accept the AXP Card, the terms and conditions for American Express® Card Acceptance ("AXP Terms and Conditions") will be sent to Merchant along with a Welcome Letter. By accepting the AXP Card for the purchase of goods and/or services, or otherwise indicating its intention to be bound, the Merchant agrees to be bound by the AXP Terms and Conditions.

I have downloaded and read:

Signature Box: (American Express Agreement Acceptance) To be signed on the signature page of this application: Help

Procare Software is a registered ISO of Wells Fargo Bank, N.A., Concord, CA

Officer Name: Help	Officer Title: Help
Enter the name of the person within your organization who is authorized to sign this agreement.