Appendix A
Receipt
NOTE: This document is CONFIDENTIAL and must be used exclusively for the operation of PAX programs. It may not be
duplicated, published, or disclosed without prior written permission from PAX.
.
220
A.3 EBT Card Receipts Template
Items in blue & bold are conditionally optional. If not given, these items should not be printed.
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Halving Line
Header Line #1
Editable. [Merchant Settings –Edit Header – Header Text 1]
Header Line #2
Editable. [Merchant Settings –Edit Header – Header Text 2]
Header Line #3
Editable. [Merchant Settings –Edit Header – Header Text 3]
Header Line #4
Editable. [Merchant Settings –Edit Header – Header Text 4]
Header Line #5
Editable. [Merchant Settings –Edit Header – Header Text 5]
Host Logo
Host Logo which is from host (Only available when the host provides)
<DEMO MODE>
Print this mark only when the POS terminal is in DEMO MODE
DO NOT CASH
Terminal ID:
7777777
Terminal ID of the POS terminal, Terminal ID value should be blank if POS terminal is in
Demo Mode.
04/09/2011
13:54:08
Print the current date and time
EBT Sale:
EDC Type, Transaction Type.
Here are the definitions of legal transactions.
Food Stamps
Account Type [Food Stamps | Cash Benefit | Voucher]
Transaction #
24
Transaction Number is incremental (Do not print on balance receipt, do not print if it is a
duplicated transaction)
Account:
************4393
Card Number,
Entry:
Swiped
Entry [Swiped | Manual | Contactless]
Server[132]:
Lily
Server ID and name [Merchant Settings – Additional Prompts –Server ID Mode] Void trans
don’t require.
Invoice #
31492
Invoice # [Merchant Settings – Additional Prompts – Invoice Mode]
Voucher No.
1234567
Voucher number. Only printed in voucher transaction
Amount:
200.00
Base transaction amount, balance receipt doesn’t have this field.
[Tip 1]:
1.00
Amount of tip 1, if enabled. Tip name should be printed to replace “Tip 1”
[Tip 2]:
2.00
Amount of tip 2, if enabled. Tip name should be printed to replace “Tip 2”
[Tip 3]:
3.00
Amount of tip 3, if enabled. Tip name should be printed to replace “Tip 3”
Cash Back:
20.00
Cash Back amount [Merchant Settings – Additional Prompts – Cash Back Prompt]
Merchant Fee:
20.00
Merchant Fee [Merchant Settings – Merchant Fee]
-------------------------
Total:
246.00
Total amount (Do not print if only one amount exists)
Ref. Number
88888888
Reference Number (do not print if null)
Auth. Code:
000000
Balance Inquiry should not print this line, void transactions should print the original auth
code. If no auth code, the value will be null.
Response:
APPROVED OFFLINE
Print “APPROVED OFFLINE” in demo mode
Food Stamps Balance:
32.00
Print on inquiring EBT food stamps balance or both balance
Cash Benefit: Balance:
40.00
Print on inquiring EBT cash benefit balance or both balance
VERBIAGE 1
Message available only when host provides
VERBIAGE 2
Message available only when host provides
VERBIAGE 3
Message available only when host provides
