Change Of Ownership

This form should 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

Franchise*

Quebec*

This location is in the province of QC / Cet emplacement est dans la province de QC
This location is NOT in QC / Cet emplacement N'EST PAS dans la province de QC

Popeyes

Restaurant ID / Numéro de restaurant*

Location (City) / Emplacement (Ville)*

Requested changeover date / date de changement demandee*

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

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

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

La date spécifique à laquelle vous allez prendre possession et commencer les opérations.

Remarque: La TVQ nécessite un préavis minimum de 3 jours pour planifier et faciliter votre changement de propriétaire.

Une fois ce formulaire envoyé, vous recevrez une réponse dans les 24 heures avec un numéro de référence, ainsi que des instructions supplémentaires, si nécessaire.

Requested changeover time / temps de changement demande (HR + MM)*

Enter the requested time in 12 hour format in YOUR local time zone. Please be sure to select AM or PM as appropriate.

Entrez l'heure demandée au format 12 heures dans VOTRE fuseau horaire local. Veuillez vous assurer de sélectionner AM ou PM selon le cas.

: 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.

Remarque: Vous devez effectuer votre opération ‘Fin de Jour’ au moment de le temps sélection ici . Si vous effectuez normalement la fin de la journée à un autre moment, nous discuterons des options avec vous.

Name of new owner / Nom du nouveau proprietaire*

Phone of new owner / Telephone du nouveau proprietaire*

Chase Merchant ID / Numero de Merchant de Chase

Chase PNS (... 0300000 or 029999)

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

SRM file number / MEV Numero de dossier

SRM ID number / MEV Numero d'identification

SRM access code / MEV Code d'acces

Tim Hortons QC

Restaurant ID / Numéro de restaurant*

Location (City) / Emplacement (Ville)*

Requested changeover date / date de changement demandee*

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

Note: QST requires a minimum of 3 days notice to schedule and assist in your ownership change.
Once this form has been submitted you will receive a reply within 24 hours with a reference number, along with further instructions if required.

La date spécifique à laquelle vous allez prendre possession et commencer les opérations.

Remarque: La TVQ nécessite un préavis minimum de 3 jours pour planifier et faciliter votre changement de propriétaire.

Une fois ce formulaire envoyé, vous recevrez une réponse dans les 24 heures avec un numéro de référence, ainsi que des instructions supplémentaires, si nécessaire.

Requested changeover time / temps de changement demande (HR + MM)*

Enter the requested time in 12 hour format in YOUR local time zone. Please be sure to select AM or PM as appropriate. Entrez l'heure demandée au format 12 heures dans VOTRE fuseau horaire local. Veuillez vous assurer de sélectionner AM ou PM selon le cas.

: 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.

Remarque: Vous devez effectuer votre opération ‘Fin de Jour’ au moment de le temps sélection ici . Si vous effectuez normalement la fin de la journée à un autre moment, nous discuterons des options avec vous.

Name of new owner / Nom du nouveau proprietaire*

Phone of new owner / Telephone du nouveau proprietaire*

Email of new owner / Courriel du nouveau proprietaire*

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

Name of MBD / nom de MBD (area manager / gerant regional)*

Email of MBD

Phone of MBD / phone de MBD ( (area manager / gerant regional)*

Chase Merchant ID / Numero de Merchant de Chase

Chase PNS (... 0300000 or 029999)

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

First Data (Timcard) Merchant ID / First Data (Carte Tim) Numero Merchant

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.

ValuelinkSi vous fournissez des cartes-cadeaux via Valuelink, vous devez vous assurer que Datawire Provisioning est terminé. Votre responsable First Data Relationship peut vous aider. Si vous ne garantissez pas le provisionnement, vous risquez de subir des retards avant de pouvoir commencer à traiter les cartes. Si vous avez plusieurs emplacements, le MID peut être le même pour tous. Si tel est le cas, vous devriez avoir des «ID alternatifs» uniques pour chaque emplacement.

SRM ID number / MEV Numero d'identification

SRM file number / MEV Numero de dossier

SRM restaurant number / MEV Numero de l'etablissement

SRM access code / MEV Code d'acces

Williams

Restaurant ID number*

Location (City)*

Requested date of changeover*

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

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

Once this form has been submitted you will receive a reply within 24 hours 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. Please be sure to select AM or PM as appropriate.

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

Once this form has been submitted you will receive a reply within 24 hours 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. Please be sure to select AM or PM as appropriate.

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

Once this form has been submitted you will receive a reply within 24 hours 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. Please be sure to select AM or PM as appropriate.

: 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 / Commentaires Supplémentaires

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

Si vous avez rempli ce formulaire entièrement, le changement de propriétaire devrait se faire sans heurt à l'heure et à la date que vous avez choisies. Veuillez utiliser cet espace pour ajouter toute information supplémentaire que vous estimez devoir connaître.

Additional Comments

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

Agreement to billing / Accord de facturation*

I Agree / J'accepte

** 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. The Submit button will appear when the 'I agree' box above has been checked.

** Un bon de travail facturable (qui inclut la main-d'œuvre et les déplacements sur site) sera requis, car un technicien est nécessaire pour programmer manuellement le MEV avec les informations que vous soumettez avec ce formulaire.

En soumettant ce formulaire, le nouveau propriétaire reconnaît et accepte de payer les coûts associés par emplacement, par changement de propriété. Le bouton Envoyer apparaît lorsque la case «J'accepte» ci-dessus a été cochée.

Agreement to billing*

I agree

By submitting this form, the new owner acknowledges and agrees to pay the administration fee of $110 per location, per ownership change. The Submit button will appear when the 'I agree' box above has been checked.

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

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

** Veuillez noter que la QST exige un minimum de trois (3) jours ouvrables pour traiter et planifier les demandes de changement de propriété. **

Si vous ne pouvez pas remplir tous les champs obligatoires de ce formulaire, veuillez contacter notre service d'assistance au 800 463-7655 pour obtenir de l'aide.

CAPTCHA

This form should be completed and submitted by the new owner.

Popeyes

Tim Hortons QC

Williams

Dairy Queen

Mary Browns