Request Logo Usage

1. Date Logo Response is Needed

Date Logo Response is Needed

2. Contact Information

First Name

Last Name

Job Title

Company

Phone (Format 8882223333)

Fax

Email (Will not be shared)

3. Corporate Information

Name of company requesting permission

Street Address

City

State

Zip Code

Company Web Site Address

Industry

4. Current Relationship with First Data

An agreement between your company and First Data (including any of its subsidiaries or affiliated companies) exists

Please enter the name or type of agreement

Who is your First Data contact? Complete the following section for that person.

First Data Contact Name

Job Title

Phone Number

Email Address

Merchant ID (for current merchant customers)

5. Logo Request Details

Check all that apply First Data TeleCheck Other Please specify

Formats EPS (CMYK) TIFF (CMYK) JPEG (RGB) GIF (RGB)

6. Logo Usage Details

Describe in detail how your company intends to use the logo(s), including the format (brochure, poster, banner, web site, etc.), country (U.S. and/or international), and audience with which the logo is proposed to be used.

Indicate the start and end dates the logo(s) will be used.

Start Date

End Date

Approximately how many people will be exposed to the materials displaying the logo(s)?

A sample showing intended use of logo(s) requested can be provided.

Address

5565 Glenridge Connector NE, Suite 2000
Atlanta, GA 30342

Phone

+1 404 890-2000

Toll Free
When calling from outside the US, international rates may apply.

+1 800 735-3362

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