PAYMENT INTEGRATION - TECHNICAL CONSULTANT REQUEST FORM

PAYMENT INTEGRATION - TECHNICAL CONSULTANT REQUEST FORM
PARTNER INFORMATION:
Cartis North American Payment Solutions Corp
Mayer Hyman, President
888-712-0770
Mayer@cartispayments.com
https://cartispayments.com/
VENDOR INFORMATION
Vendor Company Name:
Technical Contact:

First NameLast Name
Title/Position:
Phone Number:

Area CodePhone Number
Email:
example@example.com
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Website:
Supported Industries (select all that apply):

eCommerceMOTORetailRestaurantLodging
INTEGRATION SCOPE
Supported Region (select all that apply):

CanadaUSA
Project Target Start Date:

MonthDayYear
Date
Project Target Completion Date:

MonthDayYear
Date
Pilot Customer:
Processing Environment (select all that apply):

eCommerceCard Present (Terminal / PIN pad)MOTO (Card Not Present)
Click to see solutions overview
Integration Solution CNP:

Converge HPPConverge LightboxConverge Checkout.jsConverge XML APIFusebox
Integration Solution CP:

Commerce SDKSimplifyTerminal Semi Integration
TECHNICAL SCOPE / TRANSACTION DETAILS
Operating System of POS for Integration:

WindowsAndroidiOSOther
Is tokenization a requirement?

YesNo
Will token migration be required?

YesNo
Please provide details regarding token migration:
Transaction Types (select all that apply):

SaleAuthorization OnlyVoidRefundRecurringForceMulti CurrencyDynamic CurrencyOther
Payment Types (select all that apply):

CreditDebitInteracGift CardPayPalOther
Mobile Wallet Support (select if applicable):

Apple PayGoogle PaySmsung PayOther
Value Add Services (select if applicable)

Account UpdaterPayment Core 365Other
SYNOPSES OF INTEGRATION

Use this section to provide additional detail of what you are looking to accomplish and any other technical detail relevant to the integration. If a phased approach is being taken (i.e. multiple integration types, multiple regions) please state which integration will be completed in priority sequence.
OPPORTUNITY SIZE
What is the estimated number of merchants you expect to board through us?
How much annual credit card processing volume do you intend to bring in?
What is the average transaction size?
You may have heard about the new Canadian Anti-Spam Law (CASL), which went into effect July 1, 2014. In order to keep our list in compliance with the law, we need you to expressly let us know you want to receive emails from us. Update your preferences below.*

AgreeDisagree
Should be Empty:

PAYMENT INTEGRATION - TECHNICAL CONSULTANT REQUEST FORM

VENDOR INFORMATION

INTEGRATION SCOPE

TECHNICAL SCOPE / TRANSACTION DETAILS

SYNOPSES OF INTEGRATION

OPPORTUNITY SIZE