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2022-05-19T03:25:02+00:00
First Amerinet EMV Upgrade Questionnaire
Please fill out the fields below.
Company Name
Email Address
*
Contact Person Name
Contact Person Phone Number
SALESPERSON
Product Services Interested In
EMV Upgrade Kit
Fuel POS System
Fuel Dispensers
Tanks
ATG
Self Serv Kiosk
Digital Signage
Video Surveillance
ATM
Pay at the Pump Card Processing
Inside Card Processing
Installation
Other
# of Checkout Terminals
POS Sales
Hot Food
Grocery Produce
Service Station/ Repairs
Lottery
House Accounts
Fleet Cards
Gift Cards
Other
Average Monthly Credit Card Processing Volume (Submit Recent Statement)
ATG System
Veeder Root
Other
None
Pump Manufacturer
Gilbarco
Wayne
Bennett
Tokeim
Other
Pump Model
Fleet Card Acceptance
None
WEX
Fuelman
Other
Card Processing Network
First Data
Heartland
Chase/ Paymentech
Worldpay/ /FIS
Other
Average Gallons Sold Per Month
Installation Preference
Get pricing with installation estimates
Request to use existing installer I already have a contract with
I want to learn more about my installation options
Additional Notes/ Comments/ Questions
*
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