Terminal No
Make/ Model -
POS System? No
POS Name -
Payment Gateway Or Online Shopping Cart? No
Name -
Any other Software? :
noDoes The Merchant Want To Keep Their Current Equipment? :
YesFront & Back picture of terminal attached? :
YesLine Of Communication: Is Merchant Using IP :
WifiDoes Merchant Accept Gift Cards Or Want To Accept Them? :
NoDoes Merchant have a need for ACH recurring billing? :
-Does Merchant Need Next Day Funding :
NoWhat Pricing Program Does The Merchant Want? :
Traditional Pricing ProgramSpecial Request :
testMP / AP Name :
-RP Name :
-Terminal front Download
Terminal back Download
Statement Upload Download