ATM Operator Agreement and/or ATM Source of Funds Provider Declaration AgreementOperator Agreement • September 27th, 2021
Contract Type FiledSeptember 27th, 2021Section A Terminal Deployment Location [Requires completion] 1. Name of Location (Doing Business As) 2. Physical Street Address of Location 3. City, State, Zip of Location 4. Location Phone Number 5. Business Tax ID Number of merchant 6.Type of Business (Sole Proprietor, Partnership, LLC, Corporation, Financial Institution) 7. Merchandise/Services Sold where terminal is deployed 8. Financial Institution Number (FI#, FDIC, NCUA, ASI) Section B Deployed Terminal Information [Requires completion] 9. Terminal Identification Number 10. Processor of deployed terminal Section C Applicant is an Individual or a Sole Proprietor 11. Applicant First Name 12. Applicant Last Name 13. Applicant (Home) Physical Street Address 14. Applicant (Home) City, State, Zip 15. Applicant Social Security Number 16. Applicant Date of Birth (mm/dd/yyyy) 17. Applicant Home or Mobile Phone Number Section D Applicant is a Company (Partnership, LLC, Corporation, Financial Institution) 18. Company Legal Name as stated o
ATM Operator Agreement and/or ATM Source of Funds Provider Declaration AgreementOperator Agreement • December 28th, 2018
Contract Type FiledDecember 28th, 2018Section A Terminal Deployment Location [Requires completion] 1. Name of Location (Doing Business As) 2. Physical Street Address of Location 3. City, State, Zip of Location 4. Location Phone Number 5. Business Tax ID Number of merchant 6.Type of Business (Sole Proprietor, Partnership, LLC, Corporation, Financial Institution) 7. Merchandise/Services Sold where terminal is deployed 8. Financial Institution Number (FI#, FDIC, NCUA, ASI) Section B Deployed Terminal Information [Requires completion] 9. Terminal Identification Number 10. Processor of deployed terminal Section C Applicant is an Individual or a Sole Proprietor 11. Applicant First Name 12. Applicant Last Name 13. Applicant (Home) Physical Street Address 14. Applicant (Home) City, State, Zip 15. Applicant Social Security Number 16. Applicant Date of Birth (mm/dd/yyyy) 17. Applicant Home or Mobile Phone Number Section D Applicant is a Company (Partnership, LLC, Corporation, Financial Institution) 18. Company Legal Name as stated o
ATM Operator Agreement and/or ATM Source of Funds Provider Declaration Agreement MetaBank (“Bank”) (“ISO”) VOLTAGE MANAGEMENT SYSTEMS, INC. dba ATM ONEOperator Agreement • January 9th, 2017
Contract Type FiledJanuary 9th, 2017Section A Terminal Deployment Location [Requires completion] 1. Name of Location (Doing Business As) 2. Physical Street Address of Location 3. City, State, Zip of Location 4. Location Phone Number 5. Business Tax ID Number of merchant 6.Type of Business (Sole Proprietor, Partnership, LLC, Corporation, Financial Institution) 7. Merchandise/Services Sold where terminal is deployed 8. Financial Institution Number (FI#, FDIC, NCUA, ASI) Section B Deployed Terminal Information [Requires completion] 9. Terminal Identification Number 10. Processor of deployed terminal Section C Applicant is an Individual or a Sole Proprietor 11. Applicant First Name 12. Applicant Last Name 13. Applicant (Home) Physical Street Address 14. Applicant (Home) City, State, Zip 15. Applicant Social Security Number 16. Applicant Date of Birth (mm/dd/yyyy) 17. Applicant Home or Mobile Phone Number Section D Applicant is a Company (Partnership, LLC, Corporation, Financial Institution) 18. Company Legal Name as stated o
ATM Operator Agreement and/or ATM Source of Funds Provider Declaration Agreement MetaBank (“Bank”) (“ISO”) VOLTAGE MANAGEMENT SYSTEMS, INC. dba ATM ONEOperator Agreement • January 9th, 2017
Contract Type FiledJanuary 9th, 2017Section A Terminal Deployment Location [Requires completion] 1. Name of Location (Doing Business As) 2. Physical Street Address of Location 3. City, State, Zip of Location 4. Location Phone Number 5. Business Tax ID Number of merchant 6.Type of Business (Sole Proprietor, Partnership, LLC, Corporation, Financial Institution) 7. Merchandise/Services Sold where terminal is deployed 8. Financial Institution Number (FI#, FDIC, NCUA, ASI) Section B Deployed Terminal Information [Requires completion] 9. Terminal Identification Number 10. Processor of deployed terminal Section C Applicant is an Individual or a Sole Proprietor 11. Applicant First Name 12. Applicant Last Name 13. Applicant (Home) Physical Street Address 14. Applicant (Home) City, State, Zip 15. Applicant Social Security Number 16. Applicant Date of Birth (mm/dd/yyyy) 17. Applicant Home or Mobile Phone Number Section D Applicant is a Company (Partnership, LLC, Corporation, Financial Institution) 18. Company Legal Name as stated o
ATM Operator Agreement and/or ATM Source of Funds Provider Declaration AgreementOperator Agreement • November 19th, 2015
Contract Type FiledNovember 19th, 2015Section A Terminal Deployment Location [Requires completion] 1. Name of Location (Doing Business As) 2. Physical Street Address of Location 3. City, State, Zip of Location 4. Location Phone Number 5. Business Tax ID Number of merchant 6.Type of Business (Sole Proprietor, Partnership, LLC, Corporation, Financial Institution) 7. Merchandise/Services Sold where terminal is deployed 8. Financial Institution Number (FI#, FDIC, NCUA, ASI) Section B Deployed Terminal Information [Requires completion] 9. Terminal Identification Number 10. Processor of deployed terminal Section C Applicant is an Individual or a Sole Proprietor 11. Applicant First Name 12. Applicant Last Name 13. Applicant (Home) Physical Street Address 14. Applicant (Home) City, State, Zip 15. Applicant Social Security Number 16. Applicant Date of Birth (mm/dd/yyyy) 17. Applicant Home or Mobile Phone Number Section D Applicant is a Company (Partnership, LLC, Corporation, Financial Institution) 18. Company Legal Name as stated o
ATM Operator Agreement and/or ATM Source of Funds Provider Declaration AgreementOperator Agreement • December 6th, 2013
Contract Type FiledDecember 6th, 2013Section A Terminal Deployment Location [Requires completion] 1. Name of Location (Doing Business As) 2. Physical Street Address of Location 3. City, State, Zip of Location 4. Location Phone Number 5. Business Tax ID Number of merchant 6.Type of Business (Sole Proprietor, Partnership, LLC, Corporation, Financial Institution) 7. Merchandise/Services Sold where terminal is deployed 8. Financial Institution Number (FI#, FDIC, NCUA, ASI) Section B Deployed Terminal Information [Requires completion] 9. Terminal Identification Number 10. Processor of deployed terminal Section C Applicant is an Individual or a Sole Proprietor 11. Applicant First Name 12. Applicant Last Name 13. Applicant (Home) Physical Street Address 14. Applicant (Home) City, State, Zip 15. Applicant Social Security Number 16. Applicant Date of Birth (mm/dd/yyyy) 17. Applicant Home or Mobile Phone Number Section D Applicant is a Company (Partnership, LLC, Corporation, Financial Institution) 18. Company Legal Name as stated o
ATM Operator Agreement and/or ATM Source of Funds Provider Declaration AgreementOperator Agreement • December 6th, 2013
Contract Type FiledDecember 6th, 2013Section A Terminal Deployment Location [Requires completion] 1. Name of Location (Doing Business As) 2. Physical Street Address of Location 3. City, State, Zip of Location 4. Location Phone Number 5. Business Tax ID Number of merchant 6.Type of Business (Sole Proprietor, Partnership, LLC, Corporation, Financial Institution) 7. Merchandise/Services Sold where terminal is deployed 8. Financial Institution Number (FI#, FDIC, NCUA, ASI) Section B Deployed Terminal Information [Requires completion] 9. Terminal Identification Number 10. Processor of deployed terminal Section C Applicant is an Individual or a Sole Proprietor 11. Applicant First Name 12. Applicant Last Name 13. Applicant (Home) Physical Street Address 14. Applicant (Home) City, State, Zip 15. Applicant Social Security Number 16. Applicant Date of Birth (mm/dd/yyyy) 17. Applicant Home or Mobile Phone Number Section D Applicant is a Company (Partnership, LLC, Corporation, Financial Institution) 18. Company Legal Name as stated o
ATM Operator Agreement and/or ATM Source of Funds Provider Declaration AgreementOperator Agreement • December 6th, 2013
Contract Type FiledDecember 6th, 2013Section A Terminal Deployment Location [Requires completion] 1. Name of Location (Doing Business As) 2. Physical Street Address of Location 3. City, State, Zip of Location 4. Location Phone Number 5. Business Tax ID Number of merchant 6.Type of Business (Sole Proprietor, Partnership, LLC, Corporation, Financial Institution) 7. Merchandise/Services Sold where terminal is deployed 8. Financial Institution Number (FI#, FDIC, NCUA, ASI) Section B Deployed Terminal Information [Requires completion] 9. Terminal Identification Number 10. Processor of deployed terminalCDS Section C Applicant is an Individual or a Sole Proprietor 11. Applicant First Name 12. Applicant Last Name 13. Applicant (Home) Physical Street Address 14. Applicant (Home) City, State, Zip 15. Applicant Social Security Number 16. Applicant Date of Birth (mm/dd/yyyy) 17. Applicant Home or Mobile Phone Number Section D Applicant is a Company (Partnership, LLC, Corporation, Financial Institution) 18. Company Legal Name as state