Application Form

Merchant Account Application
Please, fill out the boxes below and we will make a merchant account application at one of our acquirers.
Company Registration Number*
Company Name*
Company Address*
URL / website*
Phone*
E-mail*
- Yes please - I would like to be contacted with an offer!
- Yes please - I'm ready to apply and submit my merchant agreement now!
Incorporation Certificate, Articles of Association, Shareholders Certificate*
Director
According to anti-money laundering regulations we are obligated to know your company's top management.
Full name*
Social Security number*
Address*
Zip code*
City*
Country*
Photo Legitimation*
Address Legitimation*
Utility bill in English, not older than 90 days, as a proof of the home address
Company Ownership
According to anti-money laundering regulations we are obligated to know who owns (directly or indirectly) more than 25% of your company.
Ownership
- The merchant is a sole proprietorship owned by the director
- The merchant is a sole proprietorship not owned by the director
- One or more owners are holding a direct or indirect share of more than 25%
- No owners are holding a direct or indirect share of more than 25%
Legal Owner
Full name*
Social Security number*
Address*
Zip code*
City*
Country*
Ownership (%)*
Photo Legitimation*
Address Legitimation*
Utility bill in English, not older than 90 days, as a proof of the home address
Add a Legal Owner
Add one more legal owner with more than 25% ownership
Full name
Social Security number
Address
Zip code
City
Country
Ownership (%)
Photo Legitimation
Address Legitimation
Utility bill in English, not older than 90 days, as a proof of the home address
Add a Legal Owner
Add one more legal owner with more than 25% ownership
Full name
Social Security number
Address
Zip code
City
Country
Ownership (%)
Photo Legitimation
Address Legitimation
Utility bill in English, not older than 90 days, as a proof of the home address
Add a Legal Owner
Add one more legal owner with more than 25% ownership
Full name
Social Security number
Address
Zip code
City
Country
Ownership (%)
Photo Legitimation
Address Legitimation
Utility bill in English, not older than 90 days, as a proof of the home address
Website
List your website(s) below.*
Is the website functional?
- Yes
- No
Proof of domain ownership*
It must show that the company owns the URL
Webshop System*
Product/Price Plan
Business Model
Please shortly describe your business model and products and services.
Trading Name (DBA/Descriptor)*
What services are offered on the website?*
*
- We have recurring payments
- We physically deliver our products
Which was your previous payment processor?
Las6 6 months processing history (incl. refunds, chargebacks, fraud)*
Alternatively, attach a Business Plan
Which cards would you like to accept?*
- Dankort
- Visa
- MasterCard
- MobilePay
- Others
Bank Account for Settlements
Bank Name*
Currency*
IBAN*
SWIFT*
Signed bank letter (incl. IBAN) as a proof of the company bank account*
Email for Invoices
Terms & Conditions
Read the T&C
Terms & Conditions*
- I accept and confirm that I have read the T&C
- I authorise Gate2payments to sign the Merchant Agreement on my behalf

Save if you would like to proceed

Merchant Account Application

Director

Company Ownership

Legal Owner

Add a Legal Owner

Add a Legal Owner

Add a Legal Owner

Website

Business Model

Bank Account for Settlements

Terms & Conditions