All fields required First Name:  Last Name:  Business Name:  Business Phone:  eg 949-555-1212 Email:  Merchant services provided by Applied Merchant. 1 year term agreement required * Authorize.Net is a web-based program that gives you full control of your account from virtually anywhere. Your customers will be able to pay you directly from your ShopPal web site and funds are deposited right into your checking account. You’ll also be able to process real-time transactions and get instant authorizations from any computer connected to the Internet with the Authorize.Net Virtual Terminal. Give your new business the competitive advantage it needs with this comprehensive solution. Your Account Includes: FREE application & setup NO gateway fee NO monthly minimum requirements Your own direct merchant account Daily settlement and deposits of your transactions Integrated address verification service and fraud/risk management tools Online reporting of all transaction activity

1 North Franklin Street, Suite 2360 Chicago, IL 60606 Toll-Free: (800) 675-6573 Fax: (312) 341-1568 E-Mail: info@appliedmerchant.com Applied Merchant Systems is a registered ISO and MSP of HSBC Bank USA, National Association, Buffalo NY and BancorpSouth Bank, Tupelo, MS. Copyright © 2006 Applied Merchant Systems, All rights reserved.