TPI Adv ACH Form

Teapioca International

ACH DEPOSIT REQUEST FORM & REPORT
ROYALTY-SUBJECTED AMOUNT CALCULATOR

- Please the calculators below to produce the Royalty-Subjected Total Amount
YesNo
NET SALES AMOUNT CALCULATOR README

The Royalty-Subject Amount Calculator will help you to determine the total amount which subjects to royalty
- Gross Sales: Gross Sales amount from the POS Report
- Total Tax: Total Tax amount from the POS Report
- Gross Void: Void amount from the POS Report
- Loyalty: Loyalty amount from the POS Report
Net Sales = Gross Sales - (Total Tax + Gross Void + Loyalty)

Net Sales Amount Calculator

Rows	Amount
Gross Sales
Total Tax Collected
Gross Void
Loyalty

Net Sales
YesNo
TOTAL DISCOUNT CALCULATOR README

The Total Discount Calculator will help you to sum up the total discount amount which is NOT subject to the royalty fee
- Your Sales Tax (%): This is the sales tax percentage of your location. This will be used internally to calculate the tax for the Mandated Discounts.
- Mandated Discounts: This is the total amount of the discounts with the -M in the report for the POS report.
- Void Discount: Any void discount from the POS report.
- Void Discount Tax: Any void discount tax from the POS Report.

Total Discount Calculator

Rows	Amount
Store Sales Tax (%)
Mandated Discounts
Void Discount
Void Discount Tax

Total Discount Amount
ROYALTY-SUBJECTED AMOUNT

- Note: The royalty-subjected amount is Net Sales Amount - Discount Amount which is not subject to the royalty. The royalty-subjected amount will be used in the ACH Calculation
Royalty-Subjected Amount
GO TO NEXT PAGE TO FILL OUT THE ACH FORM AND SUBMIT --->

ACH DEPOSIT REQUEST FORM & REPORT

Please fill out the following form for each period ending. You are required by the open of business on the Tuesday of the week after the period ending to fill this form to Teapioca International, by 9:00am CST Wednesday to avoid late fees. Additionally, failure to make timely and accurate reports may result in a default under your Franchise Agreement.
1 . Store Information

- Please enter the required fields:
- Store ID: Your Store ID
- Store Name: Name of the location
- Email: the email of the submitter.
- LLC Name: The business entity name.
Store ID *
Plaza Name *
For Example: Scofield Farms
Email*
A copy of the submission will be sent to this email
LLC name*
2 . ACH Week

- Please select the ACH Week. ACH Week starts from Monday until Sunday.
Week Begin Date*

MonthDayYear
Date
Week End Date*

MonthDayYear
Date
3. Amounts

- Please enter the required amounts below.
- Royalty(%): The Royalty Percentage of the location
- National Marketing (%): The National Marketing percentage.
- POS License(s): By default, the Intranet Fee includes 1 POS License. If the location has multiple POS Licenses, set the appropriate number of POS Licenses.
Please Enter Royalty (%)*
Please Enter National Marketing (%)*
NoYes
Please Enter The Number of POS Licenses*
If you have additional license(s), please change the value. The default is 1
4. Totals

- The totals below are calculated based on the entered amounts

- Royalty-Subjected Amount is from the calculation from the previous page.
Royalty-Subjected Amount
Royalty TOTAL
National Marketing TOTAL
Intranet Fee Amount
5. ACH Total

- Please review the ACH TOTAL below
Total Fees to ACH
6. Upload Proofs

- Check the checkbox to certify and upload the local advertising expenditure or 500K in Sale
Upload the proof of your local advertising expenditure

Cancelof
Upload the proof of 500K in Sales

Cancelof
7. Sign, Review & Submit

I certify that the information that I have provided to Teapioca International is true and correct. I hold Teapioca International harmless for any damages arising from the verification of this or other information I have provided.
Signature*

Powered by Jotform SignClear
Should be Empty:

Teapioca International