Valutec Card Solutions: A Metavante Company
Resources
Merchant Information:
 Company Name:
 
 Number of Locations:
 
 Mailing Address :
 
 City:
State:
 Zip Code :
 
 Phone Number :
 
 Fax Number :
 Email Address :
 
Referrer Information:
Company Name:
 
Referral ID (if known):
 
Your Name:
 
Your Phone:
 
Your Email Address:
 
Referrer Details:
Has the merchant already agreed to a credit card processing contract?
Yes
No
Undecided
If YES, what equipment will be used?
Yes
No
Terminal make and model:
Comments:
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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