OTC Equipment Upgrade Form

BUSINESS INFORMATION
We are excited to upgrade your terminal for InComm Payments NEW TRNSX platform. 

Please fill out all the data below and ALL fields with an * asterisk are required and must be completed to submit your request.

Name company is registered with the state

Business Name on the building

ex: 111-111-1111

Mobile Phone number is required to receive a one-time password once the Terminal or Web Access is received. 

ex: 111-111-1111

This is used to configure terminal for transaction purposes.

NEW TERMINAL DEVICE OPTIONS (SELECT ONE) 


If locations require more than one Terminal at their location and the terminal requested is more than what was originally contracted. There will be an additional $150.00 charge per terminal added to the current contract.

BUSINESS ADDRESS INFORMATION

ex: 123 SW Main Street

ex: Suite, Building




BUSINESS BILLING INFORMATION

ex: 123 SW Main Street

ex: Suite, Building




ex: 111-11-1111
VERIFY PRINCIPAL INFORMATION
Note: All Principal information is required and should include the business owner's personal information only




ex: 111-111-1111



ex: 123 SW Main Street

ex: Suite; Building



AS A REMINDER:  ALL VX520 TERMINALS WILL NEED TO BE RETURNED TO INCOMM TWO WEEKS AFTER YOUR NEW TERMINAL RECEIVED DATE. USE THE RETURN LABEL INCLUDED IN YOUR NEW TERMINAL BOX AND SHIP YOUR OLD EQUIPMENT TO OUR INCOMM WAREHOUSE BELOW:

 INCOMM WAREHOUSE
555 INTERNATIONAL PARK SUITE 100 NEWNAN, GEORGIA 30265


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