UPS Ground Included! UPS 2-Day Air + $15 UPS Overnight + $25

Email Tracking Number to:

Free Equipment Placement Form Fax Back to

1-800-344-3495

I. The Merchant agrees that the equipment is the property of DCS, is being licensed to the merchant, and must be returned in good and working condition within ten (10) days after the termination of the account with DCS. If the equipment is not returned within ten (10) days the merchant will be charged Fair Market Value for the equipment, no less then four hundred fifty dollars; late return penalty of fifty dollars; plus a restocking fee of ten percent. In addition, Merchant agrees to be held responsible for any damage to the equipment as a result of misuse or negligence. DCS re-serves the right to replace the above model with a comparable model if needed. Merchant understands that additional monthly fees may apply for Internet Gateway and/or Wireless Network fees for Package B or C and may be charged by DCS or via a third party.

II. By the merchant signature below, the above named merchant acknowledges the above Terminal/Equipment Order and the Terms and Conditions

contained within. This agreement shall remain in effect during the entire duration of the Merchant Account. A $49.00 Activation fee will be as-sessed to the merchant account for installation, handling and programming services. Unless an insurance binder naming DCS as loss payee for the above equipment is received prior to the acceptance by DCS, the undersigned agrees to pay an Insurance Fee of $5.95 per month per piece of equipment. Merchant agrees to indemnify and hold DCS harmless from and against any and all liabilities, losses, claims and damages of any kind in any way related to the use or misuse of the Equipment. This includes any damage to the Equipment resulting from an act of nature, fire, theft misuse or negligence by the merchant or it’s agents. Merchant also agrees to pay DCS a Replacement Handling fee of $79.00 for each deliv-ery of replacement Equipment, regardless of the reason. Comparable replacement equipment may be new or refurbished, of a different brand or model. Replacements are limited to one (1) in any consecutive twelve (12) month period. DCS reserves the right to amend the terms of this agree-ment at any time.

X Signature of Merchant Name Printed Title Date

Free Equinox Terminal T4205/T4220 Thermal Printer White Back-Light Display Plug-and-Play

Free Computer Software with Swiper Global Transport Virtual Terminal Process from Any Computer No Installation Required Recurring Billing Capable Retail or Mail/Telephone Order

Step 1: Select Your Package and Shipping Method (Check One)

Step 3: Sign Below to accept equipment order

Step 4: Fax to 1-800-344-3495

Business Name:

By selecting this option, you understand that you must have a standard phone line. If you do not, please discuss alternatives

with your Representative.

Free SmartPhone Processing with Swiper ePN Mobile Pro Reader Process Transactions Anywhere Email Receipts to your Customers Compatible with iPhone, Android

and Blackberry products

iPhone Android Blackberry

I would like more information on: Gift Card / Loyalty Programs Check Services Programs Accepting Pin-Debit