Station Survey

First Amerinet EMV Upgrade Questionnaire

Please fill out the fields below.

Company Name

Email Address *

Contact Person Name

Contact Person Phone Number

SALESPERSON

# 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

Pump Manufacturer

Pump Model

Fleet Card Acceptance

Card Processing Network

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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