This is a form
for businesses located in the USA that are interested in purchasing an ATM
or for
business owners wanting an ATM placed at their location. .
Please fill out all fields as best you can then click on Submit at
the bottom of the page when ready to send.
All information is kept strictly confidential.
First, the person who
is filling out this form is:
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Form
Submitted By:
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Choose
one:
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Email
address:
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Please fill out all questions.
Please list a phone number for us to contact you.
We
appreciate your interest in our company!
1.
How many ATMs are you interested in?
1 ATM
2 ATMs
3 ATMs
4+ ATMs
I do not need an ATM at this time. I need ATM processing for my ATM.
2.
How many people come into your business each day.
100-200
200-300
300-400
500-600
700-1000
1000-plus
3. What
models of ATM are your interested in? Use your control key to select more
than one
4. What
type of business do you operate where you want to put this ATM?
(if other
please specify):
6. Are
you interested in buying, leasing to own, or having an ATM placed at your
business?
Buying
Lease to Own
ATM Placement
Other (please specify):
8.
How soon do you want an ATM?
Anything
else you would like to tell us or comment on? When is the best time to contact
you?
Personal
contact information, or business location information:
Name of Business
Owner's Name
Business Street Address
City State
Zip
Preferred phone number we can reach you at