Order Terminals

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Practice Information
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Start Date
MM slash DD slash YYYY
Merchant ID*
You can find your merchant ID in your Poynt account portal.
Practice Name*
Contact Name*
First Last
Contact Email*
Contact Phone*

Choose your Terminals
There are two varieties of terminals to choose from.

Please Note: To ensure we can support your hardware for the life of the account, we do not allow purchasing terminals.
Poynt GoDaddy Terminal Quantity
Your practice deserves modern technology. The Poynt GoDaddy Smart Terminal is an all-in-one smart device you’ll actually want to have on your counter.
Monthly Rental: $35.00
Newland N910 Quantity
This state-of-the-art smart POS terminal N910 combines the functional flair of a smart tablet and the solidity of a payment terminal.
Monthly Rental: $25.00
Shipping Address*
Please let us know where you'd like your terminals shipped to.

Street Address Address Line 2 City State ZIP Code

Billing Information
Same as Shipping Address?
- Yes
Billing Address*
Street Address Address Line 2 City State ZIP Code
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Terminal Rental Agreement

This agreement is made on 06/05/2023 between Moolah and .

Rental Equipment: The rental equipment shall include a credit card terminal, power cord, and any necessary accessories. The rental equipment shall be delivered to , .

Rent: The rent for your equipment shall be , payable on a monthly basis. The first payment will be processed on 06/09/2023.

Use of Rental Equipment: shall use the rental equipment only for the purpose of processing credit card transactions. The customer shall not modify, repair or tamper with the rental equipment.

Damage to Rental Equipment: shall be responsible for any damage to the rental equipment during the rental term, except for normal wear and tear.

Loss or Damage: shall be responsible for the loss or damage of the rental equipment during the rental term. If the rental equipment is lost or damaged beyond repair, shall be responsible for the replacement cost of the rental equipment.

Return of Rental Equipment: shall return the rental equipment in good condition upon cancellation of the merchant account or termination of this agreement. If the rental equipment is not returned within 30 days of cancellation or is returned in damaged condition, shall be responsible for the cost of repairs or replacement.

Indemnification: shall indemnify and hold harmless Moolah from any liability, damages or claims arising out of the use of the rental equipment.

Governing Law: This agreement shall be governed by and construed in accordance with the laws of California.

Entire Agreement: This agreement contains the entire understanding between the parties and supersedes all prior negotiations, representations or agreements, whether written or oral.

Modification: This agreement may not be modified or amended except in writing signed by both parties.

Binding Effect: This agreement shall be binding upon and inure to the benefit of the parties hereto and their respective successors and assigns.
Agreement Acceptance*
I agree to the rental agreement terms.
Monthly Rental Total
Your card will be charged every month until your merchant account is cancelled and/or hardware is returned. Your first payment will process on 06/09/2023.
$0.00
Order Number
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Description

Terminal Order Form

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Practice Information

Choose your Terminals

Billing Information

Need Assistence?

800-625-1670