Submit Parameters
I am the customer
I am submitting on behalf of the customer
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Processor Contact: CC Charge Info Here
CC Profiles: |
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Required Site Info --> |
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Your Name |
Submitter Name cannot be empty!
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Customer Email |
Invalid Email Address!
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Submitter Email (required)
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Invalid Email Address!
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Site Name |
Site Name required and must begin with a letter!
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Country | ||||
Site Address |
Site Address cannot be empty!
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City |
City cannot be empty!
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State | ||||
Zip |
Zip is 5 digits!
Zip is 6 characters!
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Platform | ||||
Merchant # |
* Number
Merchant Number Must Be Numeric!
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Amex Tested OK
Amex Test Failed:
Info Here
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Terminal # |
* AlphaNumeric
Terminal Number Must Be AlphaNumeric!
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Visa Tested OK
Visa Test Failed:
Info Here
Discover Tested OK
Discover Test Failed:
Info Here
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USE TransArmor Tokenization?
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Token Identifier |
Token Id required!
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SIC |
* 4 digits (South Only)
SIC Must Be 4 digits! |
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Qual Code |
* 5 digits (South Only)
Qual Code Must Be 5 digits! |
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Time Zone | ||||
Accepted Cards |
Visa/MC
Amex * Amex SE # SE #'s are numeric! Discover * Discover SE #
SE #'s are numeric!
Diners * Diners SE #
SE #'s are numeric!
JCB * JCB SE #
SE #'s are numeric!
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Processing...!
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Notes |
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