Request for Product Demo or Dealer Referral If you need a Dealer referral and LIVE product demostration, please fill in this form Name Company Name Company Address City, State, Zip Code Email Telephone Select type of your Organization (Select that closely apply) Bank / Bank Branch? Bank Vault? Credit Union? Casino / Gaming? ATM Owner / IAD? Retail businesses? Cash-in-Transit? Law-Enforcement? Cannabis Firm / Dispensary? Other? Do you want us to refer you to one of our Authorized Dealer in your State (if one is authorized) YES NO When would you purchase and qty to purchase? The below are the list of Product / Model that one of our Authorized Dealer can show you a LIVE demonstration at your location? MIB-11V Currency Discriminator (1+1 Pocket) MIB-11F Fitness Currency Discriminator (1+1 Pocket) MIB-11VC Casino Model processing barcoded tickets & Banknotes with PC Software MIB-11VL with Banknote Serial number reading w/PC software for Law-Enforcement agency MIB-9 Currency Discriminator (1 + 1 pocket) MIB-1 Currency Discriminator - Single Pocket I accept AMROTEC® E-Commerce Website - Terms and Conditions * AMROTEC E-Commerce Website - Terms and Conditions Messages Submit