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    Merchant Application Form New

    Uploaded by

    ALPHA COLLO
    This document is a merchant application form for a payment processing partnership. It requests information about the business such as ownership structure, contact details, average transaction volumes, and bank account information. It also lists the terms of the partnership agreement, including the merchant's responsibilities to properly use the payment platform, report issues, and promote the brand. The agreement has an initial 3-year term that automatically renews, and penalties for early termination.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Merchant Application Form New

    Uploaded by

    ALPHA COLLO
    713 views2 pages
    This document is a merchant application form for a payment processing partnership. It requests information about the business such as ownership structure, contact details, average transaction volumes, and bank account information. It also lists the terms of the partnership agreement, including the merchant's responsibilities to properly use the payment platform, report issues, and promote the brand. The agreement has an initial 3-year term that automatically renews, and penalties for early termination.

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    This document is a merchant application form for a payment processing partnership. It requests information about the business such as ownership structure, contact details, average transaction volumes, and bank account information. It also lists the terms of the partnership agreement, including the merchant's responsibilities to properly use the payment platform, report issues, and promote the brand. The agreement has an initial 3-year term that automatically renews, and penalties for early termination.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    713 views2 pages

    Merchant Application Form New

    Uploaded by

    ALPHA COLLO
    This document is a merchant application form for a payment processing partnership. It requests information about the business such as ownership structure, contact details, average transaction volumes, and bank account information. It also lists the terms of the partnership agreement, including the merchant's responsibilities to properly use the payment platform, report issues, and promote the brand. The agreement has an initial 3-year term that automatically renews, and penalties for early termination.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    MERCHANT CODE: _______________________________________

    MERCHANT APPLICATION FORM


    Company Information & Business Type: Sole Proprietorship Partnership Corporation
    Business Legal Name:

    Business Trading Name:


    Date Business Started:
    Registered Office Address
    Email Address:
    Contact Numbers: (Telephone/Mobile No):
    Tax Identification No./SEC Registration No.
    Nature of Business/Activities:
    Do you have branch office? YES NO If Yes, Number of branches:________ (Please fill up list of branches form)
    Do you Accept Mobile Payments? YES NO If yes please specify :__________________________________________
    Average Monthly Sales Volumes By: Cash Cards Others:
    Highest Monthly Sales Volumes By: Cash Cards Others:
    Percentage of Mobile Payment Sales: Average Monthly % Highest Monthly %
    Do you want to be Partner Agent and get Rebates?
    YES NO I would like to be a Partner Agent Store and earn rebates.
    Contact Details (Business Owner
    Authorized Signatory 1 Authorized Signatory 2
    / Partners / Incorporators)
    Name and Designation:
    Present Address:
    Permanent Address:
    Birth Date and Place:
    Nationality:
    Mobile Number:
    Email Address:
    TIN Number:
    Government Issued ID:
    Signature Over Printed
    Name/Date
    Authorized Settlement Bank Details
    Account Name : Account No.:
    Bank Name & Address: Name of Authorize Signatory:
    Business Documents required for merchant application:
    1. Merchant Application Form 5. S.E.C Registration Certificate 9. 2 x 2 Picture (Authorized Rep.)
    2. Mayors Permit 6. Articles of Incorporations & By-Laws
    10. Authorized Representative’s Notarized
    3. BIR Certificate of Registration 7. DTI Business Registration Certificate Board Resolution or Board Secretary Certificate.
    4. Government ID (Authorized Rep.) 8. Passport Copy (for each owners)
    Conforme:

    By the signing of its authorized representative hereunder, the PARTNER AGENT STORE certifies that all the provided information herein are true and
    correct; that it accepts the TERMS AND CONDITIONS at the back hereof; that it gives permission to Fortune Pay to update any and all of its records with
    Fortune Pay using the information and that it further allows Fortune Pay to verify all or part of the information related to its p roducts and services, as
    Fortune Pay may deem necessary. certifies that all the provided herein are true and correct; and gives permission to Fortune Pay to update any and all
    of its records with Fortune Pay using the information, allows Fortune Pay to verify all or part of the information related to its products and services, as
    Fortune Pay may deem necessary.

    Printed Name and Signature of Authorized Signatory / Date

    MOB01-2021-01 Rv.202011-02
    TERMS AND CONDITIONS

    I. AGREEMENT
    This document, as well as other documents executed by Partner Store (herein referred to as the “Merchant”), pursuant to the
    acceptance of Fortune Pay (herein referred to as the “Service Provider”), shall be incorporated herein and made part hereof
    and shall constitute the entire agreement by and between Merchant and Service Provider. Fortune Pay is brought by Easypay
    Global EMI Corp. Any agreement pertaining to Fortune Pay and any of its services are by and in between Easypay Global EMI
    Corp. and the Partner Agent/Store/Merchant.

    II. RIGHTS, DUTIES, AND RESPONSIBILITIES OF MERCHANT


    a. Merchant shall use Fortune Pay Application for all its financial transactions relative to its application
    including but not limited to receiving of payment, cash out, transfer of wallet balance credit, and other
    analogous features catered by Fortune Pay Application
    b. Merchant shall maintain and monitor its Fortune Pay Account.
    c. Merchant shall ensure strict access to its personal usage of Fortune Pay Application and shall not share
    with other persons confidential information such as Password, Personal Identification Number (PIN), One
    Time Password (OTP), and other such information that will and/or may cause security breach and
    unauthorized use.
    d. Merchant shall use the system generated QR Code to receive payment from its customers and/or clients.
    e. Merchant shall ensure that Fortune Pay QR Codes shall be displayed prominently on its place of business.
    f. Merchant shall report within twenty-four (24) hours to Service Provider any suspicious transaction and
    any error encountered in the use of its application and other services.
    g. Merchant shall promote Service Provider’s application, Fortune Pay Application, by displaying and/or
    maintaining banners, tarpaulins, and other advertisement material, on its place of business. The Merchant
    shall also use other mediums of promotion such as social media whenever applicable.

    III. RIGHTS, DUTIES, AND RESPONSIBILITIES OF SERVICE PROVIDER


    a. Service Provider shall grant the use of its application, services, and trademark to the Merchant.
    b. Service Provider shall provide trainings, materials, tools, and assistance to the Merchant by and in view of
    this Agreement.

    IV. LIMITATION OF LIABILITY


    a. Service Provider shall have no liability for any loss incurred due to Merchant’s negligence (e.g. sharing of
    passwords, PIN, OTP, etc.).

    V. AGENCY RELATIONS
    a. This Agreement constitutes an Agency Relationship between the Merchant and the Service Provider.
    b. This Agreement shall not institute an Employee – Employer relationship amongst the parties and shall not in any
    way confer employee and/or worker rights to the Merchant.

    VI. TERM AND EARLY TERMINATION


    a. This Agreement shall become effective upon acceptance by Service Provider and shall continue in full force and
    effect for a term of three (3) years therefrom. At the end of the initial three (3) year term and at the end of every
    renewal thereafter, the Agreement will automatically renew for additional three (3) year period, unless terminated
    by Service Provider for justifiable grounds as deemed reasonable under existing laws. In the event the Merchant
    terminates this Agreement prior to the maturity of the Agreement’s term, the latter shall pay the Service Provider
    an Early Termination Fee amounting to _____________________________________ pesos Php (_______________________).
    b. Service Provider may immediately terminate this agreement for the following reasons:
    b1. Reasonable belief that Merchant is employed in practices that involve elements of fraud, or conduct deemed
    to be felonious and/or illegal under existing laws;
    b2 Reasonable belief that Merchant will constitute a risk to Service Provider by failing to meet the terms of this
    Agreement;
    b3 Breach of this Agreement; and
    b4. Other grounds that poses a risk to Service Provider’s interests.

    FOR BUSINESS USE: MERCHANT CODE: ___________________________________

    Ocular Inspection Business Store Longevity


    Documents Cash-Out Investment (FP)

    Qualified Partner On Boarding Date

    For : Easypay Global EMI Corporation Approval and


    Signature over printed name /Date:

    MOB01-2021-01 Rv.202011-02

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