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Free ATM Placement Request
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Free ATM Placement Request Form
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Free ATM Placement Request
Free ATM Placement Request Form
Type of ATM service requested:
Free Atm placement
50/50 Partnership
State
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
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HI
ID
IL
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IA
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ME
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MA
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ND
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OR
PA
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SC
SD
TN
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UT
VT
VA
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Any ATM Machines Installed at Your Location?
Yes
No
Is Alcohol Served?
Yes
No
Type Of Location
Bar/Nightclub
Bingo Hall
Bowling Alley
Gaming
Clothing Store
Convenience Store
Dispensary/CBD
Gas Station/Truck Stop
Grocery Store
Hotel/Motel
Hospital
Housing Complex
Indoor/Outdoor Mall
Office Area
Pawn Shop
Restaurant
School
Strip Club
Other
What "non cash" forms of payment do you accept?
Credit Cards
Checks
Other
Submit
