ATM Services Form

Welcome to our ATM Services Pre-Approval Form
This form is not binding. Please take a moment to fill out the fields below, so that we can formulate the best options for your business and your customers. We respect your privacy. We will keep all of your confidential information highly secured, will never sell to third-party entities, and will use it solely for the purposes of informative inquiry analysis. Once you complete and you submit this intro form, one of our account executives will contact you to discuss available options and will walk you through the entire application process so you can begin to reap the benefits as soon as possible. Thank you for your interest and we look forward to doing business with you.
Contact Information (step 1 out of 5)
Contact Name*
FirstLast
Preferred Communication Method*
Contact Phone:
Contact Email:*
Which Services Are You Interested In?*
Contact Phone:
Contact Email:*
Contact Title:
How Soon Do You Need Our Service(s)?*
Please specify what other TransNet services you are looking for:
How did you hear about us:*
Would you rather skip the next steps and have someone contact you directly?*
If "other," please specify:
Referral Name:
Please specify the source of your referral, so that we may properly acknowledge their kind contribution to our growth.
Business Group/ Trade Association:
Please mention the business group or association that you belong to. Thank you.
Member ID #:
Event Name:
Email Offer ID:
Please specify the Offer ID that was provided to you in the email, so that you may benefit from the offer that was extended to you. Thank you.
Coupon/ Offer Code:
Please specify the Coupon/ Offer Code, so that you may benefit from the offer that was extended to you. Thank you.
MID/ TID number(s) or Business Name(s) currently with TransNet:

Please note: If you are an existing client, we may be able to speed up the application process for you, as we have your data on file. Please don't hesitate to call us or email us directly, if that is the route you prefer. Thank you for your loyalty and your continued business with us.

Business Information (step 2 out of 5)
Business Legal Name*
Business Name (DBA)*
Business Address*
Street AddressAddress Line 2CityStateZIP Code
Business Contact Email (if other than Contact Email):
Business Phone No.*
Business Type*
If "Other," please specify:*
FED TAX ID (EIN or SSN):*

Owner Information (step 3 out of 5)
Owner's Name*
FirstLast
Percentage of Business Owned*
SSN#*
Date of Birth*
Driver's License#*
State of Issue*
Current Home Address*
Street AddressAddress Line 2CityStateZIP Code
Current Home Phone #*
Personal Email

Current Processing Information (step 4 out 5)
Are you currently processing with another company?
If yes, please specify the name of your current provider:
Monthly Transaction Number:

Attachments/ Last Notes (step 5 out 5)
Please upload your documents here, if applicable:
Drop files here or
Comments (additional notes, special requirements):

Step 1 of 5

Welcome to our ATM Services Pre-Approval Form

Contact Information (step 1 out of 5)

Business Information (step 2 out of 5)

Owner Information (step 3 out of 5)

Current Processing Information (step 4 out 5)

Attachments/ Last Notes (step 5 out 5)

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