Accounts and Reports

Credit Card Acceptance Questionnaire 

1. Are you currently accepting MasterCard and Visa cards for payment of goods and/or services? 
   
   Yes  No 
2. If NO, go to question 22. 
3. If YES, who is your acquiring bank?___________________________________ 
4. Who is your front-end vendor?_______________________________________ 
5. Who is your bank-end processor?____________________________________ 
6. What is your annual credit card volume?_______________________________ 
7. What is your monthly average transaction?_____________________________ 
8. What percent of your credit card sales are face-to-face with credit card present at the time of transaction?________ 
9. What percent of your sales are non-face-to-face, mail order/telephone order where the credit card is not present at the time of transaction?_________ 
10. Are there any recurring payments?     Yes     No 
11. What type of point of sale equipment are you using and how many? ____________________________ 
12. Do you own or lease your point of sale equipment?      Own    Lease Other_________________ 
13. Are you using any type of software with your PC to accept credit card transactions? Yes No 
14. If YES, what is the name of your software? ________________________________ 
15. Are you accepting the following card types? 
    Discover                Yes      No 
    American Express  Yes      No 
    Diners                    Yes      No 
    Other __________________________ 
16. When will your merchant agreement expire? _____________________________ 
17. If you should cancel your merchant agreement with your current provider, will there be a penalty?    Yes     No 
18. If YES, what are the penalties? _____________________________________ 
19. How many ticket retrievals do you receive a month? _____________________ 
20. How many chargebacks do you receive a month?___________________________ 
21. You are now finished. Go to question 26. 
22. Would you like to accept MasterCard and Visa cards at your location? Yes No 
23. If YES, what is your annual gross sale?____________________ (We will assume 10% of your gross sales will be by credit cards. If it is more than that, please let us know).  
24. What percent of your sales will be face-to-face with credit card present at the time of transaction?____ 
25. What percent of your sales will be non-face-to-face, mail order/telephone order where the credit card is not present at the time of transaction?________ 

Thank you for your time in completing this survey!

_________________________________________________ 
Agency 

_________________________________________________ ______________________
Representative Name                                                                  Phone  

Page last modified on:  August 18, 2017