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BRC
Simple PCI DSS Portal
Existing customers
Products
Countertop Card Machines
Mobile Card Machines
Portable Card Machines
Pricing
Support Centre
About
Products
Countertop Card Machines
Mobile Card Machines
Portable Card Machines
Pricing
Support Centre
About
Lead Form
Business Trading Name
*
Business Registered Name
Contact First Name
*
Contact Last Name
*
Has pricing been completed or is it required?
*
Complete
Required
Address (Incl postcode)
*
VAT/PPS Number
Eircode
Email
*
Mobile
*
Landline
Love Payments Rep Name
*
Love Payments Rep Email
*
Projected monthly card turnover
Maximum transaction value
Cashback
Yes
No
MOTO
Yes
No
Contract term
24 months
36 months
Terminal Type
Number of terminals
Terminal Price
New to Cards or Switcher?
New to cards
Switcher
Current Provider
Elavon
Worldpay
Barclaycard
Upload 1 month statement from current provider
Upload I.D.
Upload Proof of Banking
Upload Utility Bill - if Sole Trader
Supporting Information
*
I have read the following statement to the customer and the customer has agreed as follows:
*
“Do you consent to Love Payments giving your contact details to EVO Payments International, the provider of Card Pay so that they may use your details to contact you?’’
Please tick box if consent given
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