Valutec Card Solutions: A Metavante Company
 
     
Contact Information:
     
  Date (mmddyy)
 * 		State:
 *
  Company Name:
 * 		Zip:
 *
  Contact Name:
 * 		Phone Number: (no dashes)
 *
  Title:
 * 		Fax Number:
 
  Address:
 * 		Email Address:
 *
  City:
 * 		Website Address:
     
Tell Us About Your Company:
     
  How many people are in the
organization?
 * 		Is your organization INCORPORATED,
LIMITED LIABILITY COMPANY, etc ?
 *
  How many sales offices
do you have?
 * 		In what state are you
Incorporated, LLC etc.  ?
 *
  Who do you process through?
(Vital, Paymentec, NPC, etc)
 * 		What terminal(s) do you prefer
to deploy?
 *
  How many contracts does your
company write per month?
 * 		what PC software do you prefer
to deploy?
 *
  How many merchants do you
currently process?
 * 		 
     
  If you are tax exempt, please fax a resale certificate to 615-550-8235.
 
VALUTEC | PH: 615.771.8700 | FAX: 615.771.3500 | 113 Seaboard Lane, Suite A-200 Franklin, TN 37067 | Copyright 2006, Valutec Card Solutions

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