PAX S80 - EBT Card Receipts Template

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.
...................................................

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