Merchant Services Account Form

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#Post Title

Location Name*
Your Email

[email protected]
Location Address*
Street Address Address Line 2 City State ZIP Code
EIN / Tax ID*
Year Company Established
How Many Terminals Needed?*
- 0
- 1
- 2
- 3
Type of Terminals Needed?*
- Wired (Internet with Dial Backup)
- Wireless
- None
Monthly Account Needed?*
- Yes
- No
What is the PRCS System Used?
- Amano
- HubParking (Datapark)
- Secom
- Skidata
- Ticketech
- Tiba
- WPS
- No PRCS System
Opening / Takeover Date
Date Format: MM slash DD slash YYYY
Sample Check / Voided Check
Drop files here or
Please upload a Voided check and any other documents needed.

GAM Payments, LLC is a registered ISO of Wells Fargo Bank, N.A., Concord, CA. GAM Payments, LLC is a registered ISO of Synovus Bank Columbus, GA.

GAM Payments, LLC is a registered ISO of Chesapeake Bank, Kilmarnock, VA.