The following fields have not been filled out correctly:
Enter your company's general information that will appear in receipts, contracts and throughout application.
Company Name:
Initials¹:
Broker Number:
Tax ID²:
Social Security²: ² Please enter a Tax ID OR Social Security Number.
Address:
Address cont:
City:
State:
Zip Code:
First Name:
Last Name:
Phone:
Fax:
Email:
¹ Appears as receipt prefix.
Enter your company's primary location, you may enter more locations later.
Location Name (or city):
Website (if different from owner):
Email (if different from owner):
Hours:
Enter your primary users, you may enter more users later.
Username:
Password:
¹Time when system is opened to user. ²Time when system is closed to users.
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Recuring Billing Period: Monthly Quarterly Semiannually Annually
Amount: $
Set Up Fee: $
Transaction Fee: $
Address 1:
Card Type: Choose one… Visa Master Card Discover
Card Number:
Name on Card:
Exp. Date:
Code²:
Billing First Name:
Billing Last Name:
