AssuredCredit Merchant Gateway Customer Key Request Form

Original form, shown read-only for the record. Grey boxes show each field's placeholder text; lists show every option.

Form name in the original page code: AssuredCredit Merchant Gateway Customer Key Request Form 1999-2000

NOTICE: AssuredCard has been acquired by Milinx Business Group through CreditAssure Financial.^⁠[2] All merchant payment gateway services are part of the miCommerce Suite. Please contact a Milinx representative and upgrade to the new 300,000 concurrent users backend with high availability, enhanced security and global network access featuring Sun Microsystems, Oracle and Cisco.

Customer ID:

Company ID required

Terminal Profile Institution ID (first ACD account):

Institution ID XXXXYYYYC

Systems Admin Contact Person:

Systems Admin Full Name required

Systems Admin Phone:

Phone xxx-xxx-xxxx required

Systems Admin Email

Systems Admin Email X@X.com required

Admin End Point for Customer Key (if not specified will default to admin.yourdomain.com). Please include preferred payment gateway domain www.yourdomain.com/[payment-gateway]:

Address of Main Office of Systems Premises required

IMPORTANT: Domain DNS Settings update required prior to activation - CNAME Record for default admin.yourdomain.com | Add CNAME Record with 1. Host “admin” 2. Value “[unique CNAME Network ID Domain]” included in Customer Key email or mailed setup form for Hosted Admin Account access. NOTE: additional A Record may be required on some DNS services.

Systems OS Technology:

Select Systems OS Technology

• Microsoft Windows Server & SQL7
• Sun Microsystems & Oracle
• IBM & DecisionEdge
• other

Please detail OS, Database types and version numbers required

Provisioning Service (additional fees may apply):

Select Timing for Service

• 4 hour response
• 12 hours response
• 48 hours response

Preferred Customer Key Delivery Option:

Customer Key Delivery Options

• Email
• Courier
• Custom Setup

Please Send API Keybutton on the original form