Green Machine ATMs Payout Form
Direct Deposit Info (deposits around the 5th of the month):
Business Owner
*
First Name
Last Name
Business Name
*
Contact Number
*
E-mail
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
SSN/EIN
*
BANK ROUTING #
*
BANK ACCT#
*
Submit
Should be Empty: