Reporting Portal Virtual Terminal User Request

Please fill out this form to request access to Virtual Terminal.

Requestor Name

Merchant ID

Merchant DBA Name

Merchant DBA Phone #

Contact Email Address

Last 4 of DDA or Tax ID on file

Please indicate the name of person who needs access to VT

Will this person be responsible for setting up other users for VT?

Will this person need to run VT sales, voids & refunds?

Does this person currently have access to NCR Reporting Portal?

Email address for Virtual Terminal User

Multiple User Request

For Virtual Terminal access for more than one MID, please attach or list the # of MIDs needed, All MID accounts, and DBA Names for all other associated accounts user will need access to.

Drop your files here

List out additional user info below

Restricted to 10 lines

Send me a copy of my responses

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