Merchant Service Request Form

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Name

Requested Access & Equipment

If you need access to any systems or equipment, please complete this part of the document to submit your request. Whether you need access to virtual tools or physical equipment like card readers, printers, or tablets, we’re here to assist. Kindly follow the steps below to ensure everything is set up for your session, and we’ll make sure all necessary arrangements are made in a timely manner.
Requested Access & Equipment (Check all that apply)

Current Equipment Status

Please review your equipment and let us know if you have any items that need to be returned, swapped out, or are damaged. If you're experiencing issues with any equipment, or if you wish to exchange a device for another, this section is where you can submit your request. We’ll ensure that any necessary returns or replacements are processed promptly.
Do you currently have any Merchant Services equipment?
Are you requesting to return any equipment?
Is this a replacement request for lost/damaged equipment?

Banking Account Verification

(For internal review only – No account numbers should be entered on this form)
Are you updating banking account details associated with transactions?
Has the updated account been verified by the treasurer's office?