Wireless Credit Card Machine Rental Agreement Form - nova 2025

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The document is a Wireless Credit Card Machine Rental Agreement Form that outlines the process for renting a wireless point-of-sale credit card machine for events. It requires the requester to provide personal and event details, confirm PCI Compliance Training for users, and adhere to specific terms regarding equipment pickup, return, and responsibility for damages. The form also includes contact information for the Treasury Department for inquiries.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out the Requester’s Information section. Enter your Name, Department, Email Address, and Phone Number.
Provide details about your event including the Event Name, Event Date(s), and Event Location. Specify the Number of Machines Requesting (1-2) and include a Brief Description of the Event.
Indicate the Rental Period by selecting a Pick Up Date and a Date of Return for the equipment.
List all individuals who will be using the machine if different from yourself, and confirm whether they have taken the PCI Compliance Training Course.
Complete the financial sections by entering your Department’s GL Index/Fund Code and Acct Code. Indicate if you will be selling tangible items during the event.
Review the Terms of Agreement carefully before signing. Ensure you understand your responsibilities regarding equipment pick-up, return, and compliance training.
Finally, sign and date the form to confirm your agreement with all statements above.

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