Signup Form Definitions

Owned by Rachel Henin (Unlicensed)
Last updated: Jul 31, 2023 by Miles Graves
6 min read

Overview: This Implementations resource outlines boarding form fields in a chart with descriptions, data types, and examples of each field.

Field Name

Description

Data Type

Example

Field Name

Description

Data Type

Example

ACCOUNT NUMBER

Account number for business bank account

String up to 20 characters

1234567890

ACCOUNT PRIMARY

Indicates whether the Account is the 'primary' Account for the associated Entity. Only one Account associated with each Entity can be the 'primary' Account.

0 - Not primary

1 - Primary

1

ACCOUNT ROUTING

Routing number for the business bank account

String of 9 numbers

21000021

ACCOUNT TYPE

Business bank account type

8: Checking

9: Savings

10: Corporate Checking

11: Corporate Savings

10

ENTITY ADDRESS 1

Business address as filed with the IRS

String Between 1 and 1000 character

123 Main Street

ENTITY ADDRESS 2

Second line of the business address as filed with the IRS

String Between 0 and 500 character

Suite 100

ENTITY CITY

Business city as filed with the IRS

String Between 0 and 500 character

New York

ENTITY CUSTOMER PHONE

Business customer service phone number

Either empty or a string of 9 numbers

7185556666

ENTITY TIN

Federal Tax Identification Number

String of 9 numbers

123456789

ENTITY TIN TYPE

Indicates if the TIN being used is an EIN, SSN or "other/unknown" number.

1 = SSN

2 = EIN

3 = Other (default)

 

ENTITY EMAIL

Business email address

Valid email address up to 100 characters

mail@business.com

ENTITY IRS FILING NM

IRS Legal Filling Name

IRS Filling Name is required if the Business Legal Name provided is greater than 24 characters. Must match what was provided to IRS.

String Between 1 - 40 character

Business Incorporated LLC

ENTITY NAME

Legal Business Name

String Between 1 and 1000 character

Business LLC

ENTITY PHONE

Business phone number

String of 10 numbers

7185555555

ENTITY PUBLIC

Is this company a publicly owned

If the ENTITY TYPE is not 1 or 2, leave blank. If it is:
1: It is public

0: It is not public

0

ENTITY STATE

Business state as filed with the IRS

The state's 2 character postal abbreviation

NY

ENTITY TC DATE

Timestamp when Payrix T&C was accepted

Sting with 12 numbers following the YYYYMMDDHHII format

202101011200

ENTITY TC IP

IP address of user that accepted Payrix T&C

Valid IP address

123.12.12.123

ENTITY TC VERSION

Version of Payrix T&C accepted

Sting between 1 and 20 characters

FifthThird3.2

ENTITY TYPE

Legal Business Type (e.g. LLC)

0: Sole Proprietor

1: Corporation

2: Limited Liability Company

3: Partnership

5: Non-Profit Organization

6: Government Organization

2

ENTITY WEBSITE

Business website

Valid web address (include http(s)://) up to 500 characters

https://business.com

ENTITY ZIP

Business zip code as filed with the IRS

String of numbers that have either 5 or 9 characters

12345

MEMBER ADDRESS 1

Address of the primary member

String Between 1 and 1000 character

123 Main Street

MEMBER ADDRESS 2

Second line of the business address of the primary member

String Between 0 and 500 character

Suite 100

MEMBER CITIZENSHIP

The primary country where member has citizenship. Please use the 3-letter ISO code for the country .

3-letter ISO code for the country

USA

MEMBER CITY

City of the primary member

String Between 0 and 500 character

New York

MEMBER COUNTRY

Country of the primary member

The countries 3 character abbreviation.

USA

MEMBER DOB

Date of birth of the primary member

Sting with 8 numbers following the YYYYMMDD format

 

MEMBER EMAIL

Email of the primary member

 

name@company.com

MEMBER FIRST

First name of the primary member

String between 1 and 100 characters

John

MEMBER LAST

Last name of the primary member

String between 1 and 100 characters

Smith

MEMBER OWNERSHIP

Percentage of the business owned by the primary member

Number expressed in basis points

7500

MEMBER PHONE

Email address of the primary member

Valid email address up to 100 characters

mail@pesonal.com

MEMBER POLITICALLY EXPOSED

Is the primary member politically exposed

  • 1: Yes

  • 0: No

0

MEMBER PRIMARY

Indicates whether the Member is the 'primary' contact for the associated Merchant. Only one Member associated with each Merchant can be the 'primary' Member.

  • 1: Yes

  • 0: No

1

MEMBER SIGNIFICANT RESPONSIBILITY

Is the member an individual with significant responsibility for managing the merchant account such as an executive officer or senior manager (e.g., Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, Managing Member, General Partner, President, Vice President, Treasurer, or any other individual who regularly performs similar functions).

  • 1: Yes

  • 0: No

1

MEMBER SSN

Social security number of the primary member

String of 9 numbers

123456789

MEMBER STATE

State of the primary member

The state's 2 character postal abbreviation

NY

MEMBER TITLE

Relationship of the primary member to the company

String between 1 and 100 characters

CEO

MEMBER ZIP

Zip code of the primary member

String of numbers that have either 5 or 9 characters

12345

MERCHANT ADVANCED BILLING INDICATOR

Indicates whether the merchant accepts pre-purchase for products that are shipped at a later date or not currently available.

1: Yes

0: No

0

MERCHANT AMEX VOLUME

Indicates the annual AMEX sale volume for the merchant location.

If MERCHANT NEW is 1, leave it as zero. If it is 0, specified as an integer in cents. For example, $25.30 is expressed as '2530'.

100000000

MERCHANT ANNUAL CC SALES

Total amount of sales processed in the prior year

If MERCHANT NEW is 1, leave blank. If it is 0, specified as an integer in cents. For example, $25.30 is expressed as '2530'.

100000000

MERCHANT AVERAGE CC SALES

Average credit card sale amount in the previous year

If MERCHANT NEW is 1, leave blank. If it is 0, specified as an integer in cents. For example, $25.30 is expressed as '2530'.

10000

MERCHANT DBA

DBA of the business

String between 0 and 50 charters

My Business

MERCHANT ENVIRONMENT

Type of environment where the merchant will be accepting payments

  • supermarket: Supermarket

  • fuel: Fuel station

  • restaurant: Sit down restaurant

  • cardPresent: Other card present environments not listed

  • moto: Mail or Telephone

  • ecommerce: E-Commerce

ecommerce

MERCHANT ESTABLISHED

The date when the business was established

Sting with 8 numbers following the YYYYMMDD format

19701231

MERCHANT LOCATION TYPE

Description of the type of address that the business operates at.

following valid values:

77 = RETAIL STOREFRONT

78 = WAREHOUSE

79 = PRIVATE RESIDENCE

80 = OTHERS

81 = P. RES-PROF/CONSTRUCTION

 

MERCHANT MCC

MCC to use for this merchant

String of 4 numbers

8999

MERCHANT NDX SHIPPING DAYS

The number of days to ship/deliver the product.

Numeric

If the client does not ship a product, the value should be set to 0
"ndxDays" : 0,

If the client submits a value of 8 to 14, submit 14 to the boarding API

If the client submits a value of 15 to 30, submit 30 to the boarding API

If the client submits a value of anything over 30, submit 31 to the boarding API.

 

MERCHANT NEW

Is this merchant new to processing Credit Cards

1: New

0: Not new

0

MERCHANT PERCENT B2B SALES

The merchant percentage of transactions that are Business to Business.

Numeric - 3 characters

Max value 100

33

MERCHANT PERCENT ECOMM TXNS

The merchant percentage of internet originated transactions.

Numeric - 3 characters

Max value 100

33

MERCHANT PERCENT KEYED TXNS

The merchant percentage of transactions that are Card Not Present (Includes MOTO and eCommerce).

Numeric - 3 characters

Max value 100

33

MERCHANT SAQ DATE

Date when SAQ was completed.

Sting with 8 numbers following the YYYYMMDD format

20210101

MERCHANT SAQ QSA

Qualified Security Assessor (QSA) companies are independent security organizations that have been qualified by the PCI Security Standards Council to validate an entity's adherence to PCI DSS.

This field marks the name of QSA that validated the SAQ for the merchant.

Sting up to 50 characters

QSA Business Inc.

MERCHANT SAQ TYPE

A PCI Self-Assessment Questionnaire (PCI SAQ) is a merchant's statement of PCI compliance. This field marks the type of SAQ type completed by the merchant.

SAQ-A

SAQ-A-EP

SAQ-B

SAQ-B-IP

SAQ-C-VT

SAQ-C

SAQ-P2PE-HW

SAQ-D

SAQ-A

MERCHANT TC ATTESTATION

An attestation by the merchant that the information they have provided is correct and accurate to the best of their knowledge.

1: Yes

0: No

Must be set to 1

1

MERCHANT TOTAL VOLUME

The expected total volume for all credit card and ACH payments that the merchant will process for the current year.

If MERCHANT NEW is 1, leave as zero. If it is 0, specified as an integer in cents. For example, $25.30 is expressed as '2530'.

10000000

MERCHANT VISA DISCLOSURE

Did the user accept the Visa Regulation Disclosure

1: Yes

0: No

Most be set to 1

1

MERCHANT VISA DISCLOSURE DATE

Timestamp when Visa Regulation Disclosure was accepted

Sting with 12 numbers following the YYYYMMDDHHII format

202101011200

MERCHANT VISA DISCLOSURE IP

IP address of user that accepted Visa Regulation Disclosure

Valid IP address

123.12.12.123

MERCHANTS SEASONAL STATUS

Indicates if the merchant is a seasonal merchant or operates year-round.

1: Yes

0: No

1