FasCard Private Label App (PLA) Setup

CCI Reference Number(Required)

Use this number when contacting CCI for additional inquiries.

Account Information

FasCard Account Number(Required)

Number of Locations(Required)

Contact Information

Contact Name(Required)

First Last

This is the person we will be working with to build the private label app

Contact Phone(Required)

This is the phone number for the contact person

Contact Email(Required)

This is the email for the contact person

App Store Information

Name of App(Required)

This is the name that will appear in the app stores, customers will be able to search for this name to find you. 30 characters max.

Website for your business(Required)

Link to the privacy policy on your website(Required)

What is a privacy policy? https://en.wikipedia.org/wiki/Privacy_policy Need help creating a privacy policy? https://www.iubenda.com/en/privacy-and-cookie-policy-generator

DUNS number(Required)

What is a D-U-N-S Number? https://www.dnb.com/duns/what-is-a-DUNS-number.html

Business Name, as it appear on DUNS profile(Required)

For example: Business Name, LLC

Main Business Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Business Phone

Email address to receive feedback on your app(Required)

The app stores allow customers to leave feedback on your app, this is the email that this feedback will be sent to. You will be responsible for responding to feedback if desired.

Number of employees(Required)

Personal address or mailing address(Required)

Street Address Address Line 2 City State Zip Code

Image of photo ID(Required)

Accepted file types: jpg, jpeg, png, gif.

This will be used to confirm the identity as the owner of your business

Tax Identification Number (TIN)(Required)

In some cases you may be asked to also provide your social security number, please have that available if needed.

App Customization

The items in this section are not required. CCI will create the necessary assets if none are provided

Graphic Assets

Drop files here or

Accepted file types: jpg, jpeg, png, gif, Max. file size: 50 MB, Max. files: 3.

This could be a logo or other graphic asset you want included into the app.

App Store Icon

Accepted file types: jpg, jpeg, png, gif.

If you have specific requirements for your App Store Icon, please provide a 1024x1024 PNG image.

Brand Colors

List the colors you want included in the private label app. If you have specific color needs, provide the HEX color codes.

Payment Information

This field is hidden when viewing the form

Monthly Fee

The PLA monthly fee will be added to your existing monthly FasCard hosting fees once the app is launched.

How do you want to pay for the one-time setup fee?(Required)

Charge my existing FasCard ACH account

I will provide a credit / debit card

The setup fee is $2,500

Credit Card(Required)

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Billing Address(Required)