![]() CREDIT CARD |
Submit Parameters
I am the customer
I am submitting on behalf of the customer
|
Processor Contact:
http://vantiv.com
800.375.1744 |
||
Required Site Info --> |
|
|||
Your Name |
![]() |
|||
Customer Email (required) |
![]() |
|||
Submitter Email (required)
|
![]() |
|||
Site Name |
![]() |
|||
Country | ||||
Site Address |
![]() |
|||
City |
![]() |
|||
State | ||||
Zip |
![]() ![]() |
|||
Merchant # |
* 12 digits![]() |
![]() ![]() Info Here
|
||
Terminal # |
* 3 digits![]() |
![]() ![]() Info Here
![]() ![]() Info Here
|
||
Bank # |
* 4 digits![]() |
![]() ![]() Info Here
|
||
Time Zone |
Processing...!
![]() |
|||
Other |
Host Capture
|
|||
Accepted Cards |
Visa/MC
Discover
Diners
JCB
Amex
* Amex SE # ![]() |
|||
Notes |
|