PRISM TRANSFER Ajan Request

PRISM TRANSFER

Ajan Request

Your Business Name*

Department

Select

Operating Channel Type*

Branch Location (s)

Retail Location(s)

Kiosk Location (s)

Other

Equipment & Security

Please select which one applies to you:

Has Printer

Has not have Printer

Has Scanner

Has not have Scanner

Has Computer (Desktop or Laptop)

Has not Computer (Desktop or Laptop)

Has Security Cameras

Has not Security Cameras

Liquidity*

Please select which one applies to you?

$0>$50

$50 > $100

$100> $500

$500> $1000

$1000+

Bank Account*

Does have a USD account

Does not have a USD account

Does have an HTG account

Does not have an HTG account

Does have MonCash Business Account

Does not have MonCash Business Account

Number of Employees

Contact Name (Decision Maker)*

Contact Email*

Notes

Do you have any questions?

Send me a copy of my responses

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