Registration

Payments - step 1

Payments - step 1

All fields are required

MERCHANT SUMMARY

Merchant name

Legal form

Merchant street and number

Merchant PC

Merchant City

Merchant Country

Name Bank

Country Bank

Shop-URL / Website

CUSTOMER DETAILS

Director - first name

Director - last name

Director - country of residence

Director - nationality

Beneficial owner - first name

Beneficial owner - last name

Beneficial owner - country of residence

Beneficial owner - nationality

BUSINESS MODEL

Description business model / products

Main target countries + percentages

Required settlement and trx. currencies

If required: valid licenses in place?

AML / KYC Policy in place?

SALES DETAILS

Exp. monthly sales volume

Exp. monthly number of transactions

Required payment methods / products

OPERATIONAL DETAILS

Current acquirer

Reason for leaving / additional acquirer

Gateway integration ( API - Plug-in (+name) - own developped Gateway ...)

ADDITIONAL INFORMATION

Extra note if necessary

I declare that I have read the Privacy Policy. I agree with the use of my data according to the privacy policy.*