The Equipment Use Agreement (commonly referred to as FTA Form by Sales Reps) is the billing form used for Free Equipment Placement with NO lock-in period.


This form is used for:

  • Free Equipment Placement with Security Deposit
  • Free Equipment Placement with no Deposit


Again, be reminded that this is with NO lock-in period, if the merchant is required to be processing with us in a certain period of time, this is not the form you would want to fill out.


Below is how you are to fill out this form:


BUSINESS INFORMATION:

Business DBA Referred to as “Doing Business As”. This is the name of the business that is visible to the customers (storefront, window, and/or door signages).
Business Legal Name Referred to as the “IRS Name”. This is the name they file their taxes under, which can be completely different from the DBA.


FREE EQUIPMENT DEFINED:

Equipment Provided (Make & Model) Specific make and model of the device. Utilize one line item per type of device.
For two or more, indicate the number of devices needed. (e.g. (2) Dejavoo QD4)
Serial Number If known, indicate accordingly. Otherwise, write "TBD".
Security Deposit If known, indicate accordingly. Otherwise, write "N/A". 
Total Payment Due If the merchant is paying for a Security Deposit, input the total amount. Otherwise, write "N/A".
Term If the merchant is paying for a Security Deposit, indicate the number of installments. Otherwise, write "N/A".
Monthly Charge If the merchant is paying for a Security Deposit, input the monthly payment. Otherwise, write "N/A".


ACCEPTANCE AGREEMENT:

Owner's Signature Owner/Authorized Signer's signature.
Print Name Owner/Authorized Signer's full name.
Date Signed Date the document is signed.


PERSONAL GUARANTY:

Personal Guarantor's Signature Not necessarily the owner, but defaulted to be the owner/authorized signer.
Print Name Not necessarily the owner, but defaulted to be the owner/authorized signer.
Date Signed Date the document is signed.


On the SECOND PAGE, there is an INITIAL portion that the merchant needs to sign. Make sure to take note of that.