Sales Agent Name :

Sales Agent Email :

Merchant DBA Name :

Equipment Type :

Free Terminal Placement ? :

Retail/Moto/Wireless/Internet :

Pin-Based Debit Setup ? :

Check Services :

Multi Merchant Application ? :

Tip Line or Autobatch ? :

General Comments :

Submit Applications Cover Letter

Total Merchant Services (TMS) is a registered ISO/MSP for HSBC Bank USA, National Association, Buffalo, NY