Merchant Precheck Form
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| Contact Person |
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| Email Address |
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| Sales Partner name |
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Merchant Information
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| Contracting Company name |
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| DBA name |
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| Company Address |
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| Post Code / Zip |
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| City |
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| State |
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| Country |
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| Country of Incorporation |
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| Date of Incorporation |
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| Incorporation Number |
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| Url(s) that will be used |
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| Demo Login Username |
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| Demo Login Password |
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| Merchant Business Type |
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| Buisness Licence available |
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| Terminal type |
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| Start-up |
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| Current acquirer |
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| How long with current processor or acquirer (in years) |
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| Minimum TX Amount (USD) |
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| Maximum TX Amount (USD) |
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| Average TX Amount (USD) |
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| Volume Forecast [Monthly] (USD) |
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Customer countries of origin
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| Processing Currencies |
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| Others |
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| Required Payment Schemes (tick or specify) |
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| Others |
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| Desired Descriptor |
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| Average product/service delivery time in days |
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| Natural Person Requires |
| Fullname |
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| Email Address |
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| Phone |
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Home Address
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| Ownership (%) |
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Document Upload
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| Processing History (6 Month) |
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| Passport Copy (Person 1) |
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