Paymentech File Build Request Form - Dejavoo.io

ISO Information
Date of Request
MM slash DD slash YYYY
Contact Name*
Company Name*
Email*
Phone*
Programming Information
Hardware Type*
Serial #*
Industry Type*
Primary Communication Option*
- Add suggested tip lines
Option 1
Option 2
Option 3
- Add Built In Loyalty?
How many loyalty points per dollar?
How many loyalty points to reward?
What is the loyalty reward?
- Is this a multi merchant file build?
For Multiple MIDs please indicate if this is Merchant # X of Y
Paymentech Parameters
For Multiple Merchant IDs in one terminal file you will need to submit multiple submissions of this form for each MID.
Client ID*
Merchant ID*
Terminal ID*
Net Connect User Name (required for IP)
Net Connect Password (required for IP)
Receipt Header
5 lines, 24 characters per line, including spaces
Logo Upload for Receipts Header. Available on Z6 & Z11 only. Grayscale or B&W only .bmp format 320x320 down to 320x89. Ideal is 320x89.
Max. file size: 6 GB.
Receipt Trailer
5 lines, 24 characters per line, including spaces
- Deployment Required (additional $20 charge applies)
- Ship to address on Receipt Header
Alternative Address
Shipping method (costs to be added)
Special instructions (if applicable)
DeNovo Back Office Information
Merchant Full First and Last Name
Merchant Email Address
Merchant Contact Phone Number
DISCLAIMER: ISO hereby confirms that it has completed the proper procedure to verify Mercury Parameters. Dejavoo Systems makes no warranty that the downloaded data is accurate, error-free or will operate without interruption; In no event will Dejavoo be liable for indirect, incidental or consequential damages, including, without limitation, loss of income, use or information. ISO here by agrees to (i) fully release and discharge Dejavoo from all claims, demands, and causes of action it may have against Dejavoo by reason of the foregoing; and (ii) indemnify and hold Dejavoo harmless from any loss, damage, liability or costs, including reasonable attorney fees, in connection with any claim of any of its merchant customers arising out of the data download. SENDING THIS FORM ELECTRONICALLY IS AGREEMENT TO THESE TERMS.
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