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Payment Solutions Assessment Form

Business Payment Needs Assessment

Restaurant/Retail/Service/Online, etc.

Are You the Decision Maker?
Yes
No

Ex: Baked Goods, Fast Food, Retail Store, Plumbing

How Do You Currently Sell?
In Person
Online
Both
Cash
Not opened yet
Do You Have a Website?
Yes
No
Are You Planning to Accept Payments Through the Website?
Yes
No
Current Payment Processor:
Global Payments
Elavon
TD
Chase
Clover/ FD
Payfacto
Lightspeed Payments
Moneris
Other
Can You Provide a Recent Processing Statement?
Yes
No
Later
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