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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?
If they are not currently using the Heartland website to process payroll, when are they expected to be implemented by Heartland?
Heartland RM Contact Info
RM First Name  
RM Last name  
RM Email Address   
RM Phone Number
Notes