sage payment services test account request form

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Post on 23-Jan-2015

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DESCRIPTION

Form to request a test account for purposes of testing credit card and other payment integrations to Sage ERP.

TRANSCRIPT

Page 1: Sage Payment Services Test Account Request Form

SAGE PAYMENT SOLUTIONS 1750 Old Meadow Rd, Suite 300 McLean, VA 22102 Telephone: 1-800-261-0240 Facsimile: (703) 848-9457

Virtual Terminal Test Account Request Form

Please complete the fields below with all of your business/contact information so we may create your Virtual Terminal test account. You may fax the completed form to 703-991-5374 Attention: Virtual Support or email it to [email protected]. Once the account is created, we will send the login information to the email address provided below. If you have any questions about the Virtual Terminal or setting up the gateway integration you may contact Virtual Terminal technical support at 877-470-4001 or [email protected]. **Please allow one business day for us to process your request.**

Request Date: Type of Virtual Terminal Requested (Regular VT, VT3 or Donate Now): Regular (SED) Services Requested (Bankcard, Virtual Check, Shopping Cart, XML Web Services, and Vault): Bankcard, Web Services Would you like us to turn on Auto-Close (Yes or No): Sales Office ID: Sales Office/Rep. Name: Sales Rep. Contact Phone # or Email: Merchant Business Name: Merchant Business Address (including city, state and zip code): Merchant Contact Person: Merchant Phone #: Merchant Fax #: Merchant Email: