Online Request Form
Name:*
Email:*
Phone:*
Address:*
City:*
State:*
ZIP:*
Business Name:*
Type of Business:*
RETAIL
RESTAURANT
HOTEL/LODGING
INTERNET
MAIL ORDER/TELEPHONE ORDER COMPANY
OTHER*
If OTHER Please Specify:
Credit, Debit, and Private Label Card Processing
Please fill out this section if you would like more information about processing credit, debit, or private label cards.
How will you process transactions?:
SWIPED TRANSACTIONS
MANUALLY KEYED TRANSACTIONS
INTERNET
Are you currently processing credit, debit, or private label cards?:
YES
NO
Annual bankcard sales (or projected):
Average Ticket (or projected):
Do you want to accept online debit:
YES
NO
Do you need credit/debit/private label card equipment?:
YES. I WILL NEED TO PURCHASE/LEASE EQUIPMENT
NO. I HAVE EQUIPMENT TO REPROGRAM OR I HAVE AN INTERNET ACCOUNT WITH GATEWAY
Please enter model name and type of POS system/POS equipment or name of gateway:
ATMS
Please fill out this section if you would like more information regarding Automated Teller Machines.
I am interestd in:
CARD PAY PLACING AN ATM IN MY BUSINESS
LEASING/PURCHASING ATM
PROCESSING WITH CARD PAY WITH MY EXISITING ATM*
Enter make and model of ATM:
Please enter the text you see:
7110 SW Hazelfern Rd., Suite 260
Tigard, OR 97224
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Card Pay is a registered Independent Sales Organization of Wells Fargo Bank, N.A., Concord, CA.
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Card Pay
and
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Card Pay, 7110 SW Hazelfern Rd., Suite 260, Tigard, OR 97224 + (503) 384-0131 + cardpaysolve.com + 12/3/2024 + Page Phrases: Bank card processing Portland OR +
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