Merchant
Application Form
MERCHANT APPLICATION FORM Page 1 of 8
Merchant Application Form
IMPORTANT NOTICE
Please ensure that once the MAF (Merchant Application Form) is For best results, please
completed, it must be saved using “Save” or “Save As PDF” option, not download the form and complete
“Print as PDF.” This ensures our database can be properly updated to it using Adobe Reader, rather
ensure quick and smooth submission to the acquirer(s) of choice. than your web browser.
CORPORATION DETAILS
Legal name of company:
Doing business as (DBA - optional): Legal entity type:
Select entity type
Registered address:
City: Country of incorporation: Zip code:
Business address (if different from the incorporation address):
City: Country: Zip code:
Company incorporation date: Company registration number: VAT number:
If your business requires license
License number: License place of issue:
Number of employees: Estimated annual turnover in EUR:
Other Parent/subsidiaries (please provide company organigram): Do you have a physical office?
Yes No Yes No
Describe your product/service:
Have you ever processed card payments before?
Yes No
PRIMARY CONTACT
First name: Last name: Phone number:
Email address: Job title:
BANK ACCOUNT INFORMATION
Beneficiary name:
Beneficiary address (if different from company registered address):
City: Country: Zip code:
MERCHANT APPLICATION FORM Page 2 of 8
BANK ACCOUNT INFORMATION (CONT.)
Bank name:
Bank full address:
City: Country: Zip code:
Bank contact person: Bank phone number:
IBAN: Currency: Swift code: Sort code (UK accounts only):
ULTIMATE BENEFICIAL OWNER(S)
UBO 1 UBO 2 UBO 3
Percentage of share hold
First name
Last name
Date of birth
Place of birth
Nationality
Passport ID Number
Expiry date
Current home address
City
Country and Zip Code
Holds/held a political or
public position (PEP)
Source of wealth
(shareholder’s capital
origin)
DIRECTOR(S)
DIRECTOR 1 DIRECTOR 2 DIRECTOR 3
Percentage of share hold
First name
Last name
Date of birth
Place of birth
Nationality
Passport ID Number
Expiry date
Current home address
City
Country and Zip Code
Holds/held a political or
public position (PEP)
MERCHANT APPLICATION FORM Page 3 of 8
CONTACTS
NAME EMAIL PHONE
Technical contact
Integrator contact
Commercial contact
Financial/billing contact
Legal contact
Fraud/risk/chargeback
contact
GENERAL QUESTIONS
Indicate previous/current acquirer name: Length of time with current acquirer:
How long have you been in business? How long have you been accepting card payments?
Are you leaving current acquirer/requiring additional processing?
Please indicate the reason(s) for leaving your current Current monthly sales volume (EUR)
acquirer or for looking for a new/additional acquirer:
Current number of monthly transactions
Min daily amount per card (EUR)
Max daily amount per card (EUR)
What is the average ticket amount? (EUR)
What is the average delivery duration?
TOP 4 COUNTRIES YOUR CUSTOMERS COME FROM (MAKE SURE TOTAL = 100%)
COUNTRY 1 % COUNTRY 2 % COUNTRY 3 % COUNTRY 4 %
When is the customer charged for purchase?
Do you send email receipt to the cardholder when purchasing product/service? Please provide a copy of the template.
Yes No
Is the company supervised by a regulatory authority or any other licensing body?
(ex. Pharmaceutical license for your company or your supplier`s license; gaming license etc.)
Yes No
Is a fulfillment company used? If yes, please provide fulfilment company information details
Yes No
Please describe your delivery of goods/fulfilment of services timeframe:
Is a call center used? If yes, please provide fulfilment company information details
Yes No
Country of call center location (please provide copy of the agreement):
Do you have seasonal activities? Please indicate highest and lowest months
Yes No Highest and lowest months:
Does your website receive traffic from affiliate programs? If yes, please provide screening process in place to onboard and monitor affiliates
Yes No
MERCHANT APPLICATION FORM Page 4 of 8
GENERAL QUESTIONS (CONT.)
Please indicate if your company is stock listed: Do you offer memberships/trials? Trial(%): Membership(%):
Yes No Yes No
Is the cardholder automatically billed after the trial? Do customers register cards on your website for future purchases?
Yes No Yes No
Do you offer automatic recurring payments? Do you collect customers’ phone no and address ?
Yes No Yes No
Do you notify the customer before every recurring billing? If you do, when is the customer charged?
Yes No
How do you verify your customer identities?
Please describe cancellation timeframe/policy:
Please describe refunds timeframe/policy:
WEBSITE DETAILS
URL 1
Descriptor: MCC:
CS phone number: City: Years in operation: 3Ds: Recurring:
Yes No Yes No
Do you provide customer accounts? (If yes, please provide info below) Yes No
Members area credentials Username
Members area credentials Password
Test domain and credentials Domain
Test domain and credentials Username
Test domain and credentials Password
Is the submitted URL active and accepting cards? Is CVV compulsory to complete purchase? Estimated # of transactions per month:
Yes No Yes No
Description of business model:
URL 2
Descriptor: MCC:
CS phone number: City: Years in operation: 3Ds: Recurring:
Yes No Yes No
Do you provide customer accounts? (If yes, please provide info below) Yes No
Members area credentials Username
Members area credentials Password
Test domain and credentials Domain
Test domain and credentials Username
Test domain and credentials Password
Is the submitted URL active and accepting cards? Is CVV compulsory to complete purchase? Estimated # of transactions per month:
Yes No Yes No
Description of business model:
MERCHANT APPLICATION FORM Page 5 of 8
WEBSITE DETAILS (CONT.)
URL 3
Descriptor: MCC:
CS phone number: City: Years in operation: 3Ds: Recurring:
Yes No Yes No
Do you provide customer accounts? (If yes, please provide info below) Yes No
Members area credentials Username
Members area credentials Password
Test domain and credentials Domain
Test domain and credentials Username
Test domain and credentials Password
Is the submitted URL active and accepting cards? Is CVV compulsory to complete purchase? Estimated # of transactions per month:
Yes No Yes No
Description of business model:
URL 4
Descriptor: MCC:
CS phone number: City: Years in operation: 3Ds: Recurring:
Yes No Yes No
Do you provide customer accounts? (If yes, please provide info below) Yes No
Members area credentials Username
Members area credentials Password
Test domain and credentials Domain
Test domain and credentials Username
Test domain and credentials Password
Is the submitted URL active and accepting cards? Is CVV compulsory to complete purchase? Estimated # of transactions per month:
Yes No Yes No
Description of business model:
URL 5
Descriptor: MCC:
CS phone number: City: Years in operation: 3Ds: Recurring:
Yes No Yes No
Do you provide customer accounts? (If yes, please provide info below) Yes No
Members area credentials Username
Members area credentials Password
Test domain and credentials Domain
Test domain and credentials Username
Test domain and credentials Password
Is the submitted URL active and accepting cards? Is CVV compulsory to complete purchase? Estimated # of transactions per month:
Yes No Yes No
Description of business model:
MERCHANT APPLICATION FORM Page 6 of 8
PROCESSING DETAILS
Projected monthly processing volume (in EUR):
PAYMENT CHANNELS
Internet SSL Orders MOTO In APP Card present
PLEASE SPECIFY THE EXPECTED PERCENTAGE (%) CONSUMER CARD COMMERCIAL CARD
OF THE VOLUME PER CARD TYPE
PAYMENT METHODS
Visa Mastercard Others:
PROCESSING CURRENCIES
EUR USD GBP Others:
SETTLEMENT CURRENCIES
EUR USD GBP Others:
Is your website or host PCI DSS compliant? If yes, indicate the certification body and provide copy of the certificate
Yes No
Do you use fraud prevention methods? If yes, please specify and provide copy of procedures
Yes No
Are you aware of the card scheme regulations on chargebacks?
Yes No
Do you have process in place for handling Chargebacks (3rd party tools, VISA RDR,)? If yes, please specify and provide copy of procedures
Yes No
Do you block any countries for transactions? If yes, please specify and provide copy of procedures
Yes No
Please specify the name(s) of the gateway(s) connected to the merchant (up to 3 in a chain):
Fraud amount ratio for last 3 months(%): Chargeback count ratio for the last 3 months(%):
Visa: Mastercard: Visa: Mastercard:
Have there been any scheme breaches over the past 12 months? If yes, please provide details and measurements taken
Yes No
Is your business regulated by AML guidance? (If applicable) Who is your Money Laundrey Reporting Officer or
Yes No other designate? (If you are a crypto merchant)
Do you have an AML & CFT policy and procedures in place? (If applicable) Name:
Yes No
Email:
Do you screen your customers on PEP’s and sanctions lists? (If applicable)
Phone:
Yes No
Size of the current end-user database: Do you do end-user segmentation?
Yes No
What is the ratio between VIP/loyalty and normal customers (%):
Do you support Strong customer Authentication?
Yes No
If yes, specify the SCA solution name and provider:
What percentage of your payments is processed with 3D secure?
Planned go live date:
MERCHANT APPLICATION FORM Page 7 of 8
REQUIRED DOCUMENTS
Memorandum of Association and Articles of Association
Certificate of incorporation (not older than 6 weeks except for companies incorporated in UK)
If other parents/are linked to the company please provide company organigram
Proof of ownership (not older than 6 weeks except for incorporated in UK)
Proof of directorship (not older than 6 weeks except for incorporated in UK)
Power of attorney for the authorized signatories (if applicable)
Proof of domain ownership
VAT certificate or VAT exemption certificate
Rental or property agreement of the company location (or office utility bill)
Copy of passport or other governmental ID of directors, beneficial owners and authorized
signatures (driving license is not acceptable)
Utility bill (less than 3 months old) for directors, beneficial owners and authorized signatories
Settlement bank account proof (not older than 3 months)
A recent financial statement of the company (for the last 2 years)
Any business license, certificate or permit required to operate the business (if applicable)
Processing history of the last six months (If Processing History is not available due to start-up,
please provide a business plan or processing history from another project if the merchant
belongs to a wider group)
Organigram detailing the Merchant’s ownership structure - all levels back to the UBO
Fraud and Chargebacks policy and procedures (if applicable)
AML & CFT policy and procedures (if applicable)
Commercial Terms and Conditions for MOTO merchants (containing applicable cancellation
policy)
Contractual arrangements with third parties (if part of the services is provided by a third party)
Website terms and conditions
Signature: Date:
MERCHANT APPLICATION FORM Page 8 of 8