Company Details









Web site Details

Applicant’s web site login details (if applicable):













Do you preauthorise card transactions?

Do you use payment methods other than credit cards? If yes, please specify:

Please indicate if you are using shopping cart software for your web site:

Web site Content


Please specify the payment model:

When is the customer charged for purchase?

Do you send an email receipt to the cardholder when the product has been delivered/services have been rendered? If so, please provide a sample.

(Acceptable file size is 2 MB)

Do you distribute any materials and/or agreements to customers, related to the services offered? If so, please provide a sample.


Do you have an appropriate business license for your business? If so, please provide us with a copy.

Processing Details

Are you using MOTO (Mail Order, Telephone Order) account?

How do you receive your customer’s orders?

Volume divided between cardholder’s jurisdictions:



Volume divided between card types (in %):

Bank Account Information








Director(s)








Beneficial Owners









Tehnical Contacts

Merchant contact




Integrator contact




Finantial contact





REQUIRED DOCUMENTS

Incorporation documents:

1. Certificate of Incorporation

2. Memorandum and Articles of Association

3. Certificates listing the current directors, current shareholders and registered address

(Acceptable file size is 3 MB)



Personal information:

Know your customer (KYC)

KYC is the process of a business verifying the identity of its clients. KYC processes are also employed of ensuring that proposed agents, consultants, or distributors are anti-bribery compliant and are important to prevent identity theft, financial fraud, money laundering and terrorist financing.

Customer has to provide detailed anti-corruption due-diligence information to verify their probity and integrity. This is done with fulfilled questionnaire and enclosed of a ID or passport and address legitimation document of the CEO and all 25 % or more shareholders of a company. Address legitimation document proves you live at the address, stated in your ID or passport.

Passport or personal ID card. Please attach a scan of an official document with director's photo and address.
- The Passport or ID has to be in colour, it has to be clear and evident.
- ID has to be scanned on both sides (front and rear).





(Acceptable file size is 2 MB)



Address legitimation (utility bill) in colour, it has to be clear and evident. Please provide the whole page of the bill (not just the snippet). Address legitimation can be:
- Life assurance/life insurance policy, dated within the last 3 months but outside of cancellation period
- Utility bill - gas, electricity or water, dated within the last 3 months
- Telephone bill, dated within the last 3 months.
- Sky or cable TV bills, dated within the last 3 months.
- (!) We cannot accept mobile phone bills (!)





(Acceptable file size is 2 MB)



Processing statements or screenshots of current processing history showing the last 6 months monthly sales, chargebacks and refunds with volumes and counts included (digital scan copy or print screens are sufficient):
1. If there are any indications of elevated chargeback ratios, please provide an explanation as well as a chargeback reduction plan;
2. If the applying business is a startup and processing history is not available, please provide a detailed business plan including projected volumes, target markets and marketing strategies;
3. Most recent company bank statement or audited financial statements accompanied by a void check or bank letter validating the financial stability and confirming full settlement bank account details of the Applying/Overlying Company*;
4. Copy of an operating license (if applicable − e.g. pharmaceutical license, gaming license, etc.) of the Applying Company*.
* Original documents may be required upon approval. If the original documents are not available, certified copies of the original documents authenticated by a Notary Public, Attorney, Public Accountant or Consular Official to be a true copy of the original document required



(Acceptable file size is 3 MB)

Additional information

If you want to enclose additional file use this field.

(Acceptable file size is 3 MB)

PLEASE NOTE THAT ADDITIONAL DOCUMENTS MAY BE REQUIRED THROUGHOUT THE APPLICATION PROCESS DEPENDING ON THE PARTICULAR SOLUTION. TRANSLATION OF DOCUMENTS MAY BE REQUIRED IF LANGUAGE IS DIFFERENT FROM ENGLISH.
DISCLAIMER: Please note that completion of this form will not bind either Intech d.o.o. or any of our acquirers to any particular course of action and submitting of the information requested in this form shall explicitly not create contractual relations between the parties.

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