Change Of Ownership – Panasonic POS Client Portal

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*

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: 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 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*

Chase Merchant ID

Chase PNS (... 0300000 or 029999)

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

SRM file number

SRM ID number

SRM access code

Tim Hortons QC

Restaurant ID*

Location (City)*

Requested changeover date*

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 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...)

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: 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 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: 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 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: 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.

: 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*

I Agree

** 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.

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.