New Merchant Application Required Docs

REQUIRED FOR ALL ACCOUNTS:

1. Completed Merchant Application
2. Copy of Government issued ID for each Beneficial Owner (Drivers License or State ID or Passport)
3. Voided Check or Bank Letter
4. Merchant Authorized Signatures (4) on the following pages:
a. Page 1 - Section4 X
b. Page 3 - Section 8 X
c. Page 4 - Section 14 X
d. Page 4 - Section 15 X

IF THE MONTHLY VOLUME IS GREATER THAN $200,000 OR AVERAGE TICKET

IS GREATER THAN $1,000 ADD:
4. Processing Statements – (Previous 2 Months)
5. Business Financials (2 Years)
6. Personal Financials (2 Years)

IF THE ACCOUNT IS INTERNET or MOTO ADD:

7. List of URL’s
8. Bank Statements (Previous 2 Months)
9. User Name and Password for membership sites
10. Articles of Organization/Partnership Agreement/Business License

970 West 190th Street, Suite 650 Torrance, CA 90502

Phone: 949.380.0345 Fax: 800.250.8501 Toll Free: 888.775.1500
 MERCHANT PROCESSING APPLICATION
th
970 W. 190 Street, Suite 650 New Merchant Ownership Change 135 Crossways Park Drive North, Suite A
Torrance, CA 90502 | 888-775-1500 Woodbury, NY 11797 |800-267-2256
Existing MID:
1. BUSINESS INFORMATION
Legal Business Name: Doing Business As: (shown on cardholder statement)

Pavarotti Lab LLC Martí Vidal

Business Location Address: City State Zip
447 Broadway 2nd Floor Suite New York New York 10013
Billing Address (if different): City State Zip

Contact Name: Business Phone: Customer Service Phone: Fax:

Andrew Pierce (360) 743-8575 (360) 743-8575
Email Address: Website URL: Federal Tax ID:
izzopav72@outlook.es nastellaz.com 35-2759074
Time in Business: Number of Ownership: ☐Sole Proprietor ☐Partnership ☐Corporation ☐LLC State of Incorporation:
Years: 1 Months: 3 Locations:1 ☐ Non-Profit ☐Gov’t Entity ☐Other: Wyoming
Description of Goods/Services Sold: Currently Accept Credit Cards? ☐Yes Has the merchant or any of the Principals ☐ Yes
Toys and accessories If so, with whom? Shopify Payments ☐No ever had a merchant relationship terminated? ☐ No
Indicate when product/service is received (in relation to when card is charged): Publicly Traded ☐ Yes Symbol: DUNS#:
company? ☐ No
☐ Immediately ☐1-15 Days ☐ 16-30 Days ☐31-90 Days ☐91-120 Days ☐>120 Days
2. PROCESSING INFORMATION
Monthly Card Volume: American Express Volume: Average Ticket: High Ticket: ☐ Apply for Next- Day Funding
$ 100,000 $ $ 27 $ (subject to approval)

Percent Swiped: Percent Keyed: Percent Internet: Total Seasonal? ☐Yes* ■ No

☐ *must be active a minimum of 4 months
% + % + % = 100%
0 0 100 Months Active: Jan ■
Feb ■
Mar ■ Apr May ■
Jun ■
Jul ■
Aug ■ Sep Oct ■ Nov ■ Dec ■

Industry Type: ☐ Retail ☐ Restaurant Lodging ☐ Service ☐ Gov’t ☐Home Based ☐Internet ☐ Healthcare ☐Other

Does this Business use and independent Servicer that Stores, Processes, or Transmits Cardholder Information? ☐ Yes ■ No
☐
If Yes, Servicer Name: _______________________________________
3. ACH – BANK DEPOSIT
Bank Name: Phone:
Evolve Bank (360) 743-8575
Routing/Transit Number (include voided check): Account Number:
084009519 9600004880508007
4. BANK DISCLOSURE
Member Bank (Acquirer) Information: Merchant Information:
Merrick Bank Merchant DBA: Pavarotti Lab LLC
Merchant Services Department Important Merchant Responsibilities:
135 Crossways Park Drive North, Suite A 1. Ensure compliance with cardholder data security and storage requirements.
Woodbury, NY 11797 2. Maintain fraud and chargebacks below thresholds.
800-267-2256 3. Review and understand the terms of the Merchant Agreement.
Important Member Bank Responsibilities: 4. Comply with VISA Operating Regulations.
1. Merrick Bank is the only entity approved to extend acceptance of VISA products directly to a The responsibilities listed above do not supersede terms of the Merchant
Merchant. Agreement and are provided to ensure the Merchant understands some
2. Merrick Bank must be a principal (signor) to the Merchant Agreement. important obligations of each party and that the VISA Member – Merrick
3. Merrick Bank is responsible for educating Merchants on pertinent VISA Operating Regulations Bank - is the ultimate authority should the Merchant have any problems.

X X
with which Merchants must comply.
4. Merrick Bank is responsible for and must provide settlement funds to the Merchant.
5. Merrick Bank is responsible for all funds held in reserve that are derived from settlement.
Merchant’s Signature Date
Pavarotti Lab LLC 10/21/22
Merchant’s Name and Title

5. PROCESSING EQUIPMENT
Terminal Name: ☐ Equipment Purchase ☐ Equipment Lease Pin Pad: ☐Yes Auto Batch ☐AM ☐ GET Deploy
Payment Amount: ☐No time: ☐PM ☐ Agent Deploy

Payment Application Name: Version Number: Payment Gateway:

Special Instructions:

MPA V22.1 Page 1 of 4

 6. PRINCIPAL/BENEFICIAL OWNER INFORMATION – MUST INCLUDE EVERYONE WITH 25% OR MORE EQUITY INTERST
Principal # 1 Principal # 2
First Name:
Marti Last Name:
Vidal First Name: Last Name:
Position/Title: % Ownership Position/Title: % Ownership
CEO 100

Social Security Number: Date of Birth: Social Security Number: Date of Birth:
35-2759074 (EIN) 04/25/2000
Driver’s License Number: State: Driver’s License Number: State:
- NewYork
Home Address: ☐ Own Home Address: ☐ Own
447 Broadway, 2nd Floor Suite #146 ☐ Rent ☐ Rent
City State Zip City State Zip
New York New York 10013
Home Phone: Cell Phone: Home Phone: Cell Phone:
(360) 743-8575
Principal # 3 Principal # 4
First Name: Last Name: First Name: Last Name:
Position/Title: % Ownership Position/Title: % Ownership

Social Security Number: Date of Birth: Social Security Number: Date of Birth:

Driver’s License Number: State: Driver’s License Number: State:

Home Address: ☐ Own Home Address: ☐ Own

☐ Rent ☐ Rent
City State Zip City State Zip

Home Phone: Cell Phone: Home Phone: Cell Phone:

Controlling Position/: First Name: Last Name: Social Security Number:

Marti Vidal 35-2759074 (EIN) Controlling Interest? ☐ Yes
Beneficial Owner ☐ No
Date of Birth: Title: DL # & State: Email Address:
04/25/2000 CEO NY izzopav72@outlook.es
Home Address: City: State: Zip:
447 Broadway, 2nd Floor Suite #146 New York NY 10013
Has this Merchant or Principle ever filed Business or Personal Bankruptcy? ☐ Yes ☐ No IF YES, Explain:

7. PRICING INFORMATION
Rate Program (Select Program)

 Tiered*  Interchange Plus*  Flat Rate** AVS Fee: $____________

Rate | Per Item Rate | Per Item
Batch Fee: $____________
Signature Debit: ______%| $______ Discount Rate: ____________% Swipe Rate: ______%| $______
(% Over Interchange)

Discount Rate: ______%| $______ Statement Fee: $____________

Keyed/Specialty Rate: ______%| $______
(VI/MC/DS Credit) Amex Discount Rate: ____________%
Amex Discount Rate: ______%|$______ Monthly Minimum: 25.00
$____________
Other Fees that Apply
Authorization Fee: $____________
Mid-Qual Rate: ______%| $______ Qtly PCI Compliance: $14.95 / $44.95 PIN-Debit Access Fee: $____________
Amex Auth Fee: $____________
Non-Qual Rate: ______%| $______ Voice Auth Fee: $0.95/(Live)$1.50 Gateway/Mobile/Wireless
Per Item Fee: $____________ Setup Fee: $____________
(Settled Transactions)
Authorization Fee: $____________ Annual Acct Maint $99.95_______
Gateway/Mobile/Wireless
PIN-Debit Auth Fee: $____________ Monthly Fee: $____________
Amex Auth Fee: $____________ Account Change: $25.95_______
Gateway/Mobile/Wireless
EBT Auth Fee: $____________ Retrieval Request: $10.95_______ Auth Fee: $____________
PIN-Debit Auth Fee: $____________

EBT FNS#: _____________ Chargeback Fee: $35.00_______ Online Reporting: $____________

EBT Auth Fee: $____________
ACH Reject Fee: $60.00_______ Terminal Warranty: $____________
EBT FNS#: _____________
eComm Compliance: $9.95 _______ Other:__________ $____________

* Pass-through all Association Dues and Assessments, Process Support and Access Fees, and Debit Network Fees at current, applicable rates. ** Flat Rate Minimum Rates Apply.
You, as the merchant, have the option of accepting MasterCard credit cards, Visa credit cards, American Express credit cards, credit cards issued by Discover® Network,
MasterCard signature debit cards (MasterMoney Cards) or Visa signature debit cards (Check Cards) or debit cards issued by the Discover Network. If Merchant does not
. specifically indicate otherwise, the Merchant Application will be processed to accept all MasterCard, American Express, Discover Network, and Visa card types.
I elect not to accept: American Express Discover

MPA V22.1 Page 2 of 4

8. MERCHANT AGREEMENT ACCEPTANCE AND ACKNOLWEDGMENT OF DISCLOSURES
THIS APPLICATION DOES NOT CONSTITUTE A FINAL OFFER OR ACCEPTANCE OF THE APPLICANT AS A MERCHANT. This document and all exhibits hereto constitute the merchant’s
application for services of Global Electronic Technology, Inc. (GET) and its affiliated financial institutions and processors when signed by a properly authorized representative of the
owner(s). When signed as accepted by GET and Member Bank, these documents and its exhibits and offers, become integral and binding provisions of the GET and Member Bank Merchant
Services Agreement. GET is hereby authorized by the signer to verify any information provided by the Applicant in response to the questions contained in this document and all exhibits and
supporting documents provided. In connection therewith, Applicant hereby expressly authorizes GET to conduct or obtain investigations, consumer credit reports, and to contact and check
listed references and use other reasonable and legal means of investigation, without further notice to the Applicant. The results of such investigation remain the sole property of GET. The
signing party below warrants that he/she has reviewed the responses in this Application and its exhibits and supporting documents and that all such information is true and correct in all
material respects and does not omit any material information required to assure that such information is not misleading. The parties by signing below acknowledge that they have been
given express authorization to execute this agreement on behalf of the named corporation and GET.
TERM: Three (3) years. EARLY TERMINATION: The average monthly processing fees charged to the merchant for the previous twelve (12) months, or such shorter time if the merchant has
processed for less than twelve (12) months, multiplied by the number of months remaining under the agreement, or $250 whichever is greater.
By signing below, I understand that if my application is approved I will be provided with a copy of the terms and conditions which govern this agreement in the new accounts kits which will
be shipped to the mailing address shown above and that by processing a transaction with GET, this shall be considered absolute acknowledgement of the terms and conditions and the
acceptance of such to govern the relationship. Furthermore, I understand that I may cancel this agreement within the first thirty (30) days following approval by GET. If I choose to
discontinue service during this period, I must return any incentives, equipment or other consideration provided by GET within ten (10) days of the notice of cancellation. Failure to return
the above will result in the early termination fee being charged in accordance with the then in effect agreement.

□ By checking this box, Merchant opts out of receiving future commercial marketing communications from American Express.

Merchant:
Principal #1: XOfficer/Owner Signature
Marti Vidal
Printed Name and Title
X10/21/22
Date

Principal #2:
Officer/Owner Signature Printed Name and Title Date
Global Electronic Technology, Inc.:

By:
Corporate Signature Printed Name and Title Date
Merrick Bank Corporation:
By:
Signature of Corporate Officer Printed Name and Title Date

9. SITE SURVEY (To be completed by Sales Agent)

Type of Building: Merchant: ☐ Owns Is inventory consistent with ☐Yes
☐ Retail ☐Commercial ☐ Office ☐ Industrial ☐Residence ☐ Rents business described above? ☐No
Square Footage: ☐ 0-250 ☐ 251-500 ☐501-2,000 ☐ >2,000 Inspector’s Comments:

By signing below, I hereby verify that this application has been fully completed by the merchant applicant and that I have physically inspected the business premises of the
merchant at this address and the information stated above is true and correct to the best of my knowledge and belief.

Inspected by:
Signature Printed Name Date
10. SECURITY INFORMATION
Do you store account data electronically? ☐ Yes ■ No
☐ (If yes, indicate what data is stored):
☐ Card Numbers ☐ Expiration Date ☐ CVV2/CVC2 ☐Cardholder Name ☐Cardholder Address/Zip Code ☐ Magnetic Stripe Data
Are you currently PCI DSS compliant? ☐Yes Have you been subject to any ongoing or previous compromise investigations? ☐ Yes
☐ No ☐ No
Do you use a Shopping Cart ☐ Yes Name of Service: Do you utilize a Hosting ☐ Yes Name of Provider:
Service? ☐ No Provider? ☐ No
11. MOTO/INTERNET QUESTIONNAIRE (required for Internet and Mail-Order/Telephone-Order Merchants)
Where does Merchant advertise the product/service? How do the Merchant’s customers place their orders?
TikTok On the website
How are products/services delivered? What is the Refund Policy? Do you use a Fulfillment House? ☐ Yes ☐ No
If yes, name of service: Phone #:
By mail 14 days of guarantee for refunds
Bowen Agent
12. CUSTOMER IDENTIFICATION
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT: To help the government fight the funding of terrorism and money laundering activities,
Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When you
open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or
other identifying documents.
13. UNLAWFUL INTERNET GAMBLING ENFORCEMENT (UIGEA)
Prospective merchant presents minimal risk of engaging in Internet gambling? ☐Yes ■ No
☐
*If ‘NO’ is checked above, a notarized, written attestation from the merchant must be obtained, specifying that it does not and will not engage in an internet gambling
business. This letter must be signed by the contract signor.

MPA V22.1 Page 3 of 4

14. PERSONAL GUARANTOR & SURETY
Each guarantor, by signing below, hereby unconditionally and absolutely guarantees, jointly and severally, the punctual and full payment and performance when due, by
acceleration or otherwise, of all present and future obligations and liabilities which arise under the Form (including without limitation the Agreement) entered into between
Merchant and Bank and GET. Obligation as used herein includes, but is not limited to, chargeback amounts, bank fees, and expenses associated with the enforcement of the
Agreement or of this Guarantee. Capital terms not otherwise defined in this Guarantee shall have the meaning given to them in the Merchant Processing Enrollment Form (the
“Form”) and Merchant Processing Agreement (the “Agreement”) executed and delivered by Merchant to Bank and/or GET. This is a guaranty of payment and not merely of
collection. It shall not be necessary for Bank nor GET to resort to or to exhaust its remedies against Merchant or any other party liable with respect to such guaranteed
obligations, or to resort to or marshal any property held as security payment therefore, before calling upon guarantor(s). Guarantor(s) hereby waive any and all right of
subrogation against Merchant. Guarantor(s) waive(s) all notices to which guarantor(s) maybe entitled by law, and waive(s) presentment, demand for payment, protest, notice
of dishonor, and non-payment. Guarantor(s) consent(s) to any extensions of time or payment modifications that Bank and/or GET may enter into with Merchant. Each
guarantor (and each person signing this Guarantee in the case of a guarantor that is not a natural person) specifically authorizes the Bank and/or GET and any credit bureau or
other investigative agency employed by Bank and/or GET to investigate any information regarding each guarantor (and, in the case of a guarantor that is not a natural person,
each person signing this Guarantee) as Bank and/or GET deem appropriate to assess the accuracy of any information in this Guarantee or the credit, financial responsibility, or
capacity to perform in accordance with the terms of this Guarantee of each guarantor (or, in the case of a guarantor that is not a natural person, each person signing this
Guarantee). In addition, and if the foregoing Agreement is terminated, or if Merchant shall be in default of this Agreement, and Merchant’s Account does not have sufficient
funds to pay for the deconversion fees, chargebacks and/or any and all losses suffered by GET (including consequential damages and loss of profits, costs, expenses, liabilities,
and attorney’s fees), Undersigned Guarantor(s) hereby empower(s) and authorize(s) any prothonotary, clerk or attorney of any court of record within the United States or
elsewhere to appear for GET and, with or without declaration, CONFESS JUDGMENT, at any time or times against Merchant and in favor of GET or its assigns for all amount
remaining to be paid to GET pursuant to the Agreement, including but not limited to deconversion fees, chargebacks, consequential damages, loss of profits, costs, expenses
and liabilities, including attorney’s fees, with costs of suit, and interest added at the legal rate. MERCHANT has indicated above which additional services it is requesting.
MERCHANT agrees that Merrick Bank is not a party to any agreement for services from American Express and any such agreement is strictly between MERCHANT and American
Express. MERCHANT also agrees that Merrick Bank is not party to any agreement for services from GET other than merchant processing and any such agreement is strictly
between MERCHANT and GET. MERCHANT must be approved by each company and each company may send its terms and conditions to the address of MERCHANT indicated
herein upon such approval. MERCHANT agrees to be bound by such company’s terms and conditions. GET is a registered ISO/MSP of Merrick Bank.
This is a general, continuing, absolute and unconditional Guaranty that is enforceable by GET and Bank, its successors and assigns and is binding upon Guarantor and
Guarantor’s successor and assigns. The obligations of Guarantor hereunder may be terminated only as to future transactions and only by giving 90 days’ advance written
notice to GET and Bank at its address above or the termination of the Merchant Processing Agreement related to the guaranty. The revocation of this Guaranty shall not
relieve Guarantor of liability of obligations arising (including any which GET or Bank was committed to) prior to GET and Bank’s receipt of written revocation hereof, or on any
renewal or extension of such obligations.

X
Guarantor Signature (Principal #1)
Marti Vidal
Guarantor’s Printed Name (Principal #1)
X 10/21/22
Date

Guarantor Signature (Principal #2) Guarantor’s Printed Name (Principal #2) Date
15. CERTIFICATION OF BENEFICIAL OWNER(S)
To help the government fight financial crime, Federal regulation requires certain financial institutions to obtain, verify, and record information about the beneficial owners of
Legal entity customers. Legal entities can be abused to disguise involvement in terrorist financing, money laundering, tax evasion, corruption, fraud, and other financial
Crimes. Reporting the disclosure of key individuals who own or control a legal entity (i.e., the beneficial owners) helps law enforcement investigate and prosecute these
Crimes.

By signing below, I attest that I have accurately provided the name, address, date of birth, and Social Security Number, (SSN) for the following individuals (i.e. the Beneficial
Owners):

(i) 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

(ii) An Individual with significant responsibility for managing the legal entity customer (e.g., a Chief Executive Officer, Chief Financial Officer, Chief Operating
Officer, Managing Member, General Partner, President, Vice President, or Treasurer).

The number of individuals that satisfy this definition of “beneficial owner” may vary. Under section (i), depending on the factual circumstances, up to four individuals (but as few
as zero) may need to be identified. Regardless of the number of individuals identified under section (i), you must provide the identifying information of one individual under
section(ii). It is possible that in some circumstances the same individual might be identified under both sections (e.g. the President of Acme, Inc. who also holds 30% equity
interest). Thus, a completed form will contain the identifying information of at least one individual (under section (ii) and up to five individuals (i.e, one individual under section
(ii) and four 25 percent equity holders under section (i)).

Marti Vidal
I, the undersigned ______________________________________________________________, certify that all the information furnished above with regard to information for
each individual, if any, who directly or indirectly, through any contract, arrangement, understanding, relationship or otherwise, owns 25 percent or more of the equity
interest of the legal entity listed above is complete and accurate

X X 10/21/22
Signature:______________________________________________________________________________ Date:_____________________________________

For Internal Use:

Deal#: Sales Agent Name:

MCC: Sales Agent ID:

MID:

Discover MID:

970 West 190th Street, Suite 650 | Torrance, CA 90502 | Telephone: 888-775-1500 | Fax: 800-250-8501
Registered ISO/MSP Merrick Bank, Woodbury, NY

MPA V22.1 Page 4 of 4