Step 1 of 5
Business Information
Legal entity details, address, and contact information
🔍 Search existing HubSpot contact
Legal Entity
Address & Contact
Mailing Address
Business Profile
Ownership Type
Business Type
Step 2 of 5
Owner / Officer
Primary owner or guarantor information
Primary Owner
Banking Information
Step 3 of 5
Sales Profile
Processing volume, ticket size, and transaction mix
Volume & Tickets
Transaction Mix (must total 100%)
Total: 0%
Customer Mix (must total 100%)
Total: 0%
Funding & Billing
Funding Schedule
Billing Type
Step 4 of 5
Pricing & Fees
Merchant-specific rate schedule
Pricing Model
Discount Rates
Visa / MC / Discover Rate
Amex Rate
Pin Debit Rate
Credit Card Surcharge %
Per-Transaction Fees
Pin Debit Per Item
$
AVS Per Item
$
Batch Fee
$
Voice Auth
$
Gateway Per Item
$
Wireless Per Item
$
Monthly / Annual Fees
Monthly Minimum
$
Statement Fee
$
Gateway Access Fee
$
Wireless Access Fee
$
PCI Non-Compliance Fee
$
PCI Annual Fee
$
PCI Monthly Fee
$
Pin Debit Annual Fee
$
Pin Debit Access Fee
$
Wireless Activation
$
Exception Fees
Chargeback Fee
$
Retrieval Fee
$
ACH Reject Fee
$
EFT Fee
$
1099-K Reporting
$
TIN Mismatch (until validated)
$
Next Day Funding Fee
$
Same Day Funding Fee
$
Sales Rep
Step 5 of 5
Review & Submit
Confirm all details before generating the Netevia MPA
📧
✅
Application Submitted
The filled Netevia MPA has been generated, emailed, and synced to HubSpot.