Payment Terminal Activation Form

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* All fields are required.

Merchant Account Number

Please enter a valid Merchant Account Number (only numbers).

Company Name

Company Name is required.

First Name

First Name is required.

Last Name

Last Name is required.

Phone

Phone is required.

Email is required.

Device Type

Please choose a device type.

Terminal Mode

Please choose a terminal mode.

Will terminals be connected via LAN Cable?

No/Yes

Number of Terminals

Please enter the number.