Miva Store Information Work Sheet

Before the initial consultation, we ask that you fill out the following form to help us determine what your needs are and what areas to consider prior to the consultation and/or price quote. Please answer all of these items to the best of your ability. Please include any additional information at the bottom of the checklist.

Who are you? Name REQUIRED E-mail Address    REQUIRED The Basics - this information is needed to configure your Miva cart. 1) Company Name 2) Company Address 3) Company Phone # 4) Company City, State, Zip Configuration Information 1) What E-mail address do you want your orders sent to? 2) If you need to charge taxes for products purchased from within your state, what is the tax rate? 3) Shipping - by weight or by price table? Please give all details below. 4) What would you like your invoice message to say? (IE Thank you for ordering with MYCOMPANY. If you have any questions call OURNUMBER or visit our WEBSITE.) Merchant Account Information 1) Do you have a merchant account? If so, what is the name of the company? (This is only if you are going to have automated billing processing.) Merchant Accounts that work with Miva: Payment via PayPal Authorize.Net Payment Services v3.0 E-Commerce Exchange/QuickCommerce 3.0 Payment Gateway Check Payment COD e-ValuCheck - Accept checks for immediate shipment Moneris e-SELECT Payment Service GlobalCommerce Payment Gateway CyberSource ICSv2 Payment Services Cardservice/LinkPoint Payment Gateway Credit Card Payment With Simple Validation Paradata Payment Service Verisign Payflow Link Verisign Payflow Pro (PaymentNet) R-P-G (Rodopi Payment Gateway) debit-it! - Full Service Online Electronic Check Processing Innovative Gateway Solutions U.S. Merchant Systems - Accept Major Credit Cards 2) What credit cards will you accept (check all that apply): American Express Discover Mastercard Visa Other:

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