Bank Forms

Merchant Form - Bank Name

Merchant Details

CR Name

CR Number

Aggregator:

CR Expiry Date

Brand Name

Address

MCC Code

Seasonal:

Incorporation Status:

Portal Access:

MCC Title:

Total Stores:

Total POS:

Note:

Owner/Authorized Manager

Full Name:

Position Title:

Telephone:

Mobile:

Email - Statement:

Nationality:

Civil ID:

Civil Expiry

Store Details

Store Name:

Address:

Total POS:

POS Profile:

DCC Enabled:

Receipt Details

First Line:

Second Line:

Third Line:

Fourth Line:

Store Manager

Full Name:

Position Title:

Telephone:

Mobile:

Email - POS Password:

Fees and Charges Configurations(MSF)

Local Debit Fees % Local Debit Fees should not exceed 1.5% as per ABO policy

International Fees %

Setup Fees

Monthly Fees

Other Fees

Capture Account Details

Bank Name:

SWIFT Code:

Account Name:

Account No.:

Transactions Estimation

Monthly No. of Trasactions:

Ticket Size:

Submission

	Name	Stamp / Signature	Date
Merchant Manager
Cooardinator Name
Supervisor
Existing Acquirer

Status*

Complete In-Complete(Document) In-Complete(Document) On-Hold