Merchant Registration Form

Partner

Company Name *

Country of Incorporation *

MCC / Industry

Year Company Established *

Brief Description of Company

Number of MID's requried

Sales Volume Per MID required

Company URL(s)

Describe in detail the product or service you are selling & Pricing Model(High Ticket, Average Ticket, Subscription....)

Average monthly sales volume?

Average QTY of transactions per month?

What is your average ticket size?

Subscription?

YESNO

Straight Up Sale

YESNO

Indicate Chargeback Percentages & Reversal Percentages per month.

Regions do you intend to sell into and which currencies do you wish to settle

Current pain points, special requirements, additional comments or questions.Help us better understand your business challenges and needs

Contact First Name *

Contact Last Name *

Contact Email Address *

Contact Phone NumberPlease include country code.

Comparison Monthly Processing Statements

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Personal Identification

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Only upload personal identification (such as your Drivers Licence) if you have been requested to do so.

reCAPTCHA *

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