Form 1: MAP BC Conversion Payment Authorization Form

Form 1: Payment Authorization Form

The client agrees to pay 100 Percent Financed through Grey Rose Consulting LLC the appropriate fee based on the invoice for the services rendered by 100 Percent Financed. By signing below, the Client agrees that all agreed-upon services have been hereby rendered.
PLEASE READ THE INSTRUCTIONS CAREFULLY
1. Please fill out all of the needed details below.
2. Please list all business cards to be used for this transaction and the corresponding amounts to be processed.
3. Once amount is provided, you will see the following automatically:
  - Amount owed to Grey Rose Consulting LLC (5.5%)
  - Amount to be wired to your account (80%)
  - Amount that will be kept as a 12-month reserve (14.5%)
    
    On the 13th month, 100PF will return the money to you through bank transfer.
4. We only help process business credit cards only. Personal credit cards are not allowed in this transaction.
5. This process is only limited to the following clients:
  - Maximum amount to be converted PER BUSINESS CREDIT CARD per transaction should be at $10,000. For example, if you have a Chase business credit card for $40,000, then we can process four equal payments of $10,000.
CLIENT'S INFORMATION
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
PHYSICAL MAILING ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Number of business credit cards to process*
Please list all business credit cards to be used and the corresponding amounts to be processed. Please enter the full dollar amount without abbreviations. For instance, write $10000.00 instead of 10k (please don't write $10,000).*
Please key in the total amount to be processed in this field*
Amount found in Row 8, Column "Total Amount to be Processed".
Amount owed to Melio (2.9%)*
Do not edit this field.
Amount owed to GRC LLC (2.6%)*
Do not edit this field.
Remaining Funds to Hold in Escrow *
Do not edit this field.
By signing this form, you agree to pay Grey Rose Consulting, LLC 5.5% of the total amount of funding you need to process, leaving you a total percentage of funding in the amount of 94.5%. The 80% will be wired to your nominated account while the 14.5% will be kept as a 12-month reserve. On the 13th month, 100PF will return the 14.5% reserve to you through wire transfer.*

Clear
After clicking the "Submit" button, you will be redirected to another form requiring you to key-in full details of the business credit card that you're going to liquidate through Authorization.net.

Please note that if you have a total of seven business cards to liquidate, you have to process seven Authorize.Net forms.
Should be Empty:

Form 1: Payment Authorization Form

CLIENT'S INFORMATION

After clicking the "Submit" button, you will be redirected to another form requiring you to key-in full details of the business credit card that you're going to liquidate through Authorization.net.