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Merchant Application Form

Personal Information

*Full Name

Phone Number (With country code)

*Email Address

*Date of Birth

ID Type

ID Number

Country*

City Or Town

Postal Code

Is there another owner, partner, officer, or director applying?

Yes
No

Business Information

Business Name

Legal name of business, if different

Website URL

*Business Phone Number (With country code)

Country*

Street Address

City or Town

Region

Postal Code

*Business Type

In general, how many days does it take to provide your product/service?

When are your customers charged?

Business Registration Number

Business Started Date`

Where is your company based?

Type a country where you are selling product/services?

Website or Apps Platform

*What is your company's monthly revenue ?

How would you like to be contact ?

Business description

Processing Information

Do you offer subscriptions?

Industry of your company*

Refund Policy*

Projected annual credit/debit card volume

Typical transaction amount

Largest expected transaction

Are you currently processing credit cards? *

Banking Information

Account Holder Name ( Prefer your company name)

Name of Bank

Account Number

ACH/ BIC/ IBAN or SWIFT CODE ( Others Bank Code if Any)

Country

State

City or Town

Region

Street Address

Postal Code

Company registration certificate

Director IDs copy

( Kindly Attach your company Registration Certicates & Filled Document + All directors Passport/National IDs copies)

Your Message