Heartland Referral Form

Heartland/iPOS Client Referral Info

Enter the referral information for your client

Heartland Client Info
Client Company Name
Client Address 1
Client Address 2
Client City
Client State
Client ZIP
Client Phone	(Use xxx-xxx-xxxx format)
Client Heartland Company ID	If the client is currently a Heartland customer, please enter their Heartland Company ID number.
Client First Name
Client Last Name
Client Email Address
Client POS System
Is the client currently using the Heartland website to process their payroll?	NoYes
If they are not currently using the Heartland website to process payroll, when are they expected to be implemented by Heartland?