EPSG - Fort Point Payments

EPSG Agent Name :

EPSG Agent ID :

EPSG Agent Email (we can CC you on all email communications with your referrals) :

EPSG Agent Contact Number :

Merchant’s Business Name * :(Required)

Merchant’s Name * :(Required)

Email Address * :(Required)

Contact Number * :(Required)

Business Website URL :

What is the reason for sending this lead to HTP? :

Was declined by underwriting

App was never submitted due to being a prohibited business type

Is the merchant aware that they will be receiving a call from Fort Point Payments? :

Yes, I have spoken to the merchant, and they are waiting for the call

Sort of, I left a message and/or sent an email informing them that FPP would be calling them

No, I have not notified the merchant that FPP will be contacting them

Notes :

Comments

This field is for validation purposes and should be left unchanged.

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