10.3 - Credit/Debit Card Refund Receipt
DATE
99/99/99
AAAAAAAAAAAAAAAAAAAAAAAAAA
AAAAAAAAAAAAAAAAAAAAAAAAAA
AAAAAAAAAAAAAAAAAAAAAAAAAA
AAAAAAAAAAAAAAAAAAAAAAAAAA
AAAAAAAAAAAAAAAAAAAAAAAAAA
AAAAAAAAAAAAAAAAAAAAAAAAAA
CREDIT REFUND
TRAN #
AUTH
CLERK ID
DESC CODE
INVOICE #
ACCOUNT TYPE:CHECKING
CardType ACCOUNT #
9999999999999999999
TOTAL REFUND AMOUNT
X_________________________
SIGNATURE
AAAAAAAAAAAAAAAAAAAAAAAAAA
AAAAAAAAAAAAAAAAAAAAAAAAAA
AAAAAAAAAAAAAAAAAAAAAAAAAA
AAAAAAAAAAAAAAAAAAAAAAAAAA
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AAAAAAAAAAAAAAAAAAAAAAAAAA
MERCHANT COPY
or
CUSTOMER COPY
REPRINT
99999999999 TIME
999999
99:99
9999
XXXXXX
99
123456
88888888
EXP. DATE
9999
$999999.99
(On reprints only)
(Merchant ID.)
(Terminal ID.)
(Custom header information, optional
from parameters. Data is self-centered.)
(transaction type)
(for debit only)
(card type- VISA, MSTR, DEBIT, etc)
(print the last 4 digits of acct # for Debit)
(Not Present for Debit)
(Custom phrase, optional.)
(Custom phrase, optional.)
(Custom phrase, optional.)
(Custom phrase, optional.)
(Custom phrase, optional.)
(Custom phrase, optional.)
1999 TeleCheck International, Inc. CONFIDENTIAL
35
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