RESTAURANT ACCOUNT CHANGE (OR CHANGE OF OWNERSHIP)

Any account changes to the POS require this form to be completed and submitted by the (new) owner.

All fields should be completed to ensure a smooth transition. Please fill out as much of the form as possible and If you are unsure or do not have the information needed, contact your regional manager for assistance. Keep in mind that we require three business days notice to pre-schedule a changeover.

To schedule, configure and administer the necessary changes required for the change of ownership, a fee of $275 will apply.

Franchise*

Quebec*

Locations in Quebec require additional information.

This location is in the province of QC
This location is NOT in QC

Popeyes

Restaurant ID*

Location (City)*

Requested changeover date*

The specific date that you will take ownership and begin operations.

Note: Panasonic requires a minimum of 3 business days notice to schedule and assist in your ownership change.

Once this form has been submitted you will receive a reply within 24 hours on the following business day with a reference number, along with further instructions if required.

Requested changeover time (HR + MM)*

Enter the requested time in 24 hour format in YOUR local time zone.

: HH

MM

Note: You must perform an 'End Of Day' operation at the time you select here. If you normally perform end of day at another time, we will discuss the options with you for doing so.

Name of new owner*

Phone of new owner*

Email of new owner*

Email confirmation of this submission will be sent to this address.

Chase Merchant ID

Chase PNS (... 0300000 or 029999)

Chase Terminal ID's (101-104,112,201-205...)

Kiosk Terminal ID's (301-304...)

SRM file number

SRM ID number

SRM access code

HiFive Chicken

Restaurant ID*

Location (City)*

Requested changeover date*

The specific date that you will take ownership and begin operations.

Note: Panasonic requires a minimum of 3 business days notice to schedule and assist in your ownership change.

Once this form has been submitted you will receive a reply within 24 hours on the following business day with a reference number, along with further instructions if required.

Requested changeover time (HR + MM)*

Enter the requested time in 24 hour format in YOUR local time zone.

: HH

MM

Note: You must perform an 'End Of Day' operation at the time you select here. If you normally perform end of day at another time, we will discuss the options with you for doing so.

Name of new owner*

Phone of new owner*

Email of new owner*

Email confirmation of this submission will be sent to this address.

Name of MBD (area manager)*

Phone of MBD (area manager)*

Email of MBD

Chase Merchant ID

Chase PNS (... 0300000 or 029999)

Chase Terminal ID's (101-104,112,201-205...)

Kiosk Terminal ID's (301-304...)

Chaiiwala

Restaurant ID*

Location (City)*

Requested changeover date*

The specific date that you will take ownership and begin operations.

Note: Panasonic requires a minimum of 3 business days notice to schedule and assist in your ownership change.

Once this form has been submitted you will receive a reply within 24 hours on the following business day with a reference number, along with further instructions if required.

Requested changeover time (HR + MM)*

Enter the requested time in 24 hour format in YOUR local time zone.

: HH

MM

Note: You must perform an 'End Of Day' operation at the time you select here. If you normally perform end of day at another time, we will discuss the options with you for doing so.

Name of new owner*

Phone of new owner*

Email of new owner*

Email confirmation of this submission will be sent to this address.

Name of MBD (area manager)*

Email of MBD

Phone of MBD (area manager)*

Chase Merchant ID

Chase PNS (... 0300000 or 029999)

Chase Terminal ID's (101-104,112,201-205...)

Kiosk Terminal ID's (301-304...)

Tim Hortons QC

Restaurant ID*

Location (City)*

Requested changeover date*

The specific date that you will take ownership and begin operations.

Note: Panasonic requires a minimum of 3 business days notice to schedule and assist in your ownership change.

Once this form has been submitted you will receive a reply within 24 hours on the following business day with a reference number, along with further instructions if required.

Requested changeover time (HR + MM)*

Enter the requested time in 24 hour format in YOUR local time zone.

: HH

MM

Note: You must perform an 'End Of Day' operation at the time you select here. If you normally perform end of day at another time, we will discuss the options with you for doing so.

Name of new owner*

Phone of new owner*

Email of new owner*

Email confirmation of this submission will be sent to this address.

Name of MBD (area manager)*

Email of MBD

Phone of MBD (area manager)*

Chase Merchant ID

Chase PNS (... 0300000 or 029999)

Kiosk Terminal ID's (301-304...)

Chase Terminal ID's (101-104,112,201-205...)

First Data (Timcard) Merchant ID

Valuelink: If you provide Gift Cards through Valuelink you must ensure through them that Datawire Provisioning has been completed. Your First Data Relationship manager can assist with this. Failure to ensure provisioning may cause delays before you can begin processing cards. If you have multiple locations, the MID may be the same for all. If so, you should have unique 'Alternate ID's' for each location.

SRM ID number

SRM file number

SRM restaurant number

SRM access code

Williams

Restaurant ID number*

Location (City)*

Requested date of changeover*

The specific date that you will take ownership and begin operations.

Note: Panasonic requires a minimum of 3 business days notice to schedule and assist in your ownership change.

Once this form has been submitted you will receive a reply within 24 hours on the following business day with a reference number, along with further instructions if required.

Requested time of changeover (enter hours AND minutes)*

Enter the requested time in 24 hour format in YOUR local time zone.

: HH

MM

Note: You must perform an 'End Of Day' operation at the time you select here. If you normally perform end of day at another time, we will discuss the options with you for doing so.

Name of new owner*

Email of new owner*

Phone of new owner*

Global Payment Merchant ID

Global Payment ECR Number(s)

Ackroo ID for each terminal (Williams Points Card)

Dairy Queen

Restaurant ID number*

Location (City)*

Requested date of changeover*

The specific date that you will take ownership and begin operations.

Note: Panasonic requires a minimum of 3 business days notice to schedule and assist in your ownership change.

Once this form has been submitted you will receive a reply within 24 hours on the following business day with a reference number, along with further instructions if required.

Requested time of changeover (enter hours AND minutes)*

Enter the requested time in 24 hour format in YOUR local time zone.

: HH

MM

Note: You must perform an 'End Of Day' operation at the time you select here. If you normally perform end of day at another time, we will discuss the options with you for doing so.

Name of new owner*

Email of new owner*

Phone of new owner*

TD Merchant ID number

TD Pinpad ECR numbers

First Data (DQ Loyalty Card) Merchant ID

Tax #

Mary Browns

Restaurant ID number*

Location (City)*

Requested date of changeover*

The specific date that you will take ownership and begin operations.

Note: Panasonic requires a minimum of 3 business days notice to schedule and assist in your ownership change.

Once this form has been submitted you will receive a reply within 24 hours on the following business day with a reference number, along with further instructions if required.

Requested time of changeover (enter hours AND minutes)*

Enter the requested time in 12 hour format in YOUR local time zone.

: HH

MM

Note: You must perform an 'End Of Day' operation at the time you select here. If you normally perform end of day at another time, we will discuss the options with you for doing so.

Name of new owner*

Email of new owner*

Phone of new owner*

Chase Merchant ID number

Terminal Number

Chase PNS

Tax #

GIVE-X Merchant ID

HST / Tax ID

Additional Comments

Please use this space to add any additional information that you feel we should know.

Agreement to billing*

** A billable work order (which includes on site labour and travel) will be required as a tech is needed to manually program the SRM with the info you are submitting with this form

By submitting this form, the new owner acknowledges and agrees to pay the associated costs per location, per ownership change. Should the account change be cancelled, we require 24 hours notice or cancellation fee will be applied. The Submit button will appear when the 'I agree' box above has been checked.

I Agree

Agreement to billing ($275)*

By submitting this form, the new owner acknowledges and agrees to pay the configuration and administration fee of $275 per location, per ownership change. Should the account change be cancelled, we require 24 hours notice or there will be a $275 cancellation fee applied. The Submit button will appear when the 'I agree' box above has been checked.

I agree

* Please note that Panasonic requires a minimum of three (3) business days to process and schedule change of ownership requests *

** Should your account change need to occur outside the hours of 7am to 8pm EST - Monday thru Friday, additional resources will be required and OT rates of $220/hr will be applicable **

If you can not complete all the required fields on this form, please contact our help desk at 800-463-7655 for assistance.