Leasing Application Form

ATM Leasing Application

Kickstart your journey to ATM ownership and enhanced revenue with our simple leasing application process. Fill out your application today and unlock the door to tailored ATM solutions designed to fit your business’s unique needs. Let’s elevate your customer experience and boost your earnings, one transaction at a time.

Leasing Application Form

Merchant App

Step 1 of 8

12%

Section A - Terminal Deployment Location

Name of Location (Doing Business As)(Required)

Physical Street Address of Location(Required)

City, State, Zip of Location(Required)

Phone

Section A - Terminal Deployment Location - Part 2

Business Tax ID Number of merchant(Required)

Merchandise/Services Sold where terminal is deployed(Required)

Type of Business (Sole Proprietor, Partnership, LLC, Corporation, Financial Institution)(Required)

Sole Proprietor

Partnership

LLC

Corporation

Financial Institution

Financial Institution Number (FI#, FDIC, NCUA, ASI)(Required)

Section C - Applicant is an Individual

Applicant First Name(Required)

Applicant Last Name(Required)

Applicant (Home) Physical Street Address(Required)

Applicant (Home) City, State, Zip(Required)

Applicant Social Security Number(Required)

Applicant Date of Birth (mm/dd/yyyy(Required)

Section C - Applicant is an Individual - Part 2

Applicant Drivers License (Passport) Issuance Date(Required)

Applicant Drivers License (Passport) Expiration Date(Required)

Applicant Drivers License Number (Passport Number)(Required)

Applicant Drivers License Issuing State (Passport Issuing Country)(Required)

Percentage of Ownership held by Applicant(Required)

Any other names (first and last) by which Applicant is now or has been known.(Required)

Have you ever been convicted of a felony?(Required)

Yes

Have you ever been convicted of a felony?(Required)

Yes

Section D - Applicant is a Company and Principals

Applicant Company (legal) Name(Required)

Applicant Company Physical Street Address(Required)

Applicant Company City, State, Zip(Required)

Applicant Company Federal EMployer Identification Number (FEIN)(Required)

Section D - Applicant is a Company and Principals - Part 2

Principal #1 of Company: First and Last Name

Principal #1 of Company: Percent of Ownership

Principal #1 of Company: Physical (Home) Street Address

Principal #1 of Company: (Home) City, State, Zip

Principal #1 of Company: Date of Birth (mm/dd/yyyy)

Principal #1 of Company: Social Security Number

Section D - Applicant is a Company and Principals - Part 3

Principal #2 of Company: First and Last Name

Principal #2 of Company: Percent of Ownership

Principal #2 of Company: Physical (Home) Street Address

Principal #2 of Company: (Home) City, State, Zip

Principal #2 of Company: Date of Birth (mm/dd/yyyy)

Principal #2 of Company: Social Security Number

Signature

By submitting this form, you confirm that all the information provided is accurate and complete to the best of your knowledge. You understand that the accuracy of this information is crucial for the processing of your application and that any discrepancies may lead to delays or complications in service provision.

MEMBERS ONLY

RESTRICTED ACCESS

Why Choose Us

Go with Goldstar ATM for top-notch expertise and tailor-made ATM services that pop! We’re all about elevating your cash game and slashing those pesky credit card fees, wrapped up with our standout customer and tech support. With Goldstar, you get the best of both worlds: wide-reaching service with that unbeatable local vibe. We’re here, ready to boost your business, anytime, anywhere!

Affordable Prices

Buying an ATM machine is a low risk investment and most of our ATM machines sell for less than $3000.

Rent or Lease an ATM

We also offer affordable leasing and renting options.

Service & Support

When you purchase an ATM from GoldStar, we offer our highest quality 24/7 service and support.

Knowledgeable Sales Staff

Explore the perfect ATM for your location with our team's guidance on benefits and cost-effective options.

ATM Leasing Application