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 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 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 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 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 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
Terms & Conditions*
- I accept and confirm that I have read the T&C
- I authorise Gate2payments to sign the Merchant Agreement on my behalfaccepts my redemption agreement (10 days right of dispute from the merchant)

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