Terminal No
Make/ Model -
POS System? Yes
POS Name
Payment Gateway Or Online Shopping Cart? No
Name -
Any other Software? :
-Does The Merchant Want To Keep Their Current Equipment? :
YesFront & Back picture of terminal attached? :
YesLine Of Communication: Is Merchant Using IP :
-Does Merchant Accept Gift Cards Or Want To Accept Them? :
-Does Merchant have a need for ACH recurring billing? :
-Does Merchant Need Next Day Funding :
-What Pricing Program Does The Merchant Want? :
PrimeBuxxSpecial Request :
-MP / AP Name :
Patricia WrightRP Name :
-Terminal front Download