Terminal Change Form
Location Name
Your answer
Terminal ID
Your answer
Desired Date of Change
MM
/
DD
/
YYYY
Please specify what is changing (Example: Machine will be changing to a Hyosung Halo, Surcharge will be changing to $3.00)
Your answer
Setup Notes (optional)
Your answer
Authorization
Requested By
Your answer
Disclaimer
By submitting this form "you" the owner, operator of this ATM terminal are responsible for any and all ATM compliance (EMV, ADA, Fee notice, etc.) eGlobal will not be held responsible for any fees, fines or litigation brought on by failing to adhere to Network, Processor and Government regulations
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