Cashline ATMs - ATM distributor services a distribution affiliate provider

ATM Purchase Questionnaire

How soon do you need your ATM machine? *	Yesterday 2-7 days 10-30 days Other - please specify Specify if Other:

What type of business do you operate where you want the ATM Installed? *	Convenience Store Grocery Store Bar/Restaurant/Night Club Retail Outlet Bank/Credit Union High/College/University School Campus Hospital Resort/Hotel/Lodge Casino Other - please specify Specify if Other:

Are you the owner of the business where the ATM is to be located? *	Owner Manager Sub-Contractor Personal Connection Other - please specify Specify if Other:

How many ATMs do you need? *	1 2 3 4+

Approximately how many people, per day, walk into your business?*	100 - 200 200 - 300 300 - 500 500 - 700 700+

Your Name: *

Your Phone Number: *

Secondary Phone Numer:

Your E-Mail Address:*

Where is your business located? *	City: State:

What type of ATMs are you considering?*	Free-standing Wall Mounted Counter Top