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Distributor information Inquiry
Eastern Region
(Indicates required field * )
*Company Name:
*Contact Name:
*Address 1:
Address 2:
*City:
*State:
*ZIP Code:
*Phone:
Fax:
*Email:
Please tell us a little about yourself and your business so we can determine the
best way for us to work together.
(optional)
Are you currently selling ATMs?
Yes
No
If so, what type? (Check all that apply)
Nextran
Tidel
Tranax
NCR
Diebold
Wincor
Fujitsu
Greenlink
Nurit
Rhino
Other
How many ATMs do you project to purchase during a one-year timeframe?
0-50
50-100
100-250
250-500
500-1000
1000+
Will you provide your own service?
Yes
No
Who will your processor be?
ACS
Deluxe
Coredata
EPS
Concord EFS
Lynk
Other
Which Triton equipment are you interested in?
RL2000
RT2000
RL5000
FT5000
RL5000
xp
FT5000
xp
FT7000
Triton Connect
Triton Service
Triton Communication Options
Rear Load Equipment
UL 291 Level 1 Security Safes
Prism
What geographic locations will you cover?
Which market segments are you focused on?
Convenience store
Gaming
Hospitality
Restaurant/bar
Nightclub
Financial institution
Amusement
other
Do you have any comments or questions?