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MERCHANT QUESTIONNAIRE

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MERCHANT QUESTIONNAIRE IMAGE MERCHANT QUESTIONNAIRE IMAGE

Company information

Company name
Registration number
Tax ID number
Trading name (brand)
Corporate web site

Business information

Owner of a domain name
Billing descriptor
Login information
Test login details (username)
Test login details (password)
Actual address
URL address with contact information
Regularity of e-shop updates for:
Range of goods
Customer services rules
Is support /customer service available 24/7
Contact details of customer service
Telephone
E-mail
Other
MCC code
Are there any subscription products/services offered?
Do you have restrictions/URL access blocking from certain countries
Do you have your own goods stock
Do you have a physical store
Main suppliers/courier companies
Full Name
Web-page
Shipping terms (delivery/execution time and delivery methods)
Target market
Lowest goods/services price
Highest goods/services price
Current average amount of one transaction
Current monthly turnover (only for this store)
Average monthly chargeback ratio
Average monthly number of chargebacks
Average monthly number of reversal/refunds
Average monthly number of fraud transactions

Ceo, president or director

Name
Surname
Telephone
E-mail
Messaging apps (Whatsapp, Telegram)

Main contact for business development

Name
Surname
Telephone
E-mail
Messaging apps (Whatsapp, Telegram)

Head of finance (authorized to receive statements)

Name
Surname
Telephone
E-mail
Messaging apps (Whatsapp, Telegram)

Refund, chargebacks, risk assessment, sensitive issues

Name
Surname
Telephone
E-mail
Messaging apps (Whatsapp, Telegram)

Customer support

Name
Surname
Telephone
E-mail
Messaging apps (Whatsapp, Telegram)

Head of customer support

Name
Surname
Telephone
E-mail
Messaging apps (Whatsapp, Telegram)

Project manager for integration issues

Name
Surname
Telephone
E-mail
Messaging apps (Whatsapp, Telegram)

Requested urls and forecast Specify parameters for the first six months

Transaction number
next month
+2 month
+3 month
+4 month
+5 month
+6 month
Total volume
next month
+2 month
+3 month
+4 month
+5 month
+6 month
Chargeback amount
next month
+2 month
+3 month
+4 month
+5 month
+6 month
Chargeback ratio
next month
+2 month
+3 month
+4 month
+5 month
+6 month

Requested urls and forecast Specify parameters for the first six months

Processing history for last 6 months(Average monthly chargeback ratio, number of chargebacks, number of reversal/refunds, number of fraud transactions). If not available, bank statement)
Existing AML/KYC procedures
PCI DSS Certificate
Agreements with AML/KYC vendors/tools
Warehouse lease agreement (if applicable)
Agreement with a transport company (if applicable)

By signing the present questionnaire the representative of the merchant hereby confirms, that:

  • the Merchant undertakes to promptly inform the Organization about any changes in therange of products and services indicated in the present Questionnaire;
  • all information provided above is complete and reliable, and the Merchant undertakes topromptly inform the Organization about any changes in the information provided above;
  • he/she is authorized to represent the Merchant and has the right on behalf of the Merchantto submit the information indicated in the present Questionnaire, which is binding to theMerchant and the Organization;
  • he/she is informed about the responsibility, including criminal responsibility, for the provisionof knowingly false or incomplete information;
  • he/she is familiar with the General provisions of transactions and Tariffs of the Organization,agrees to them and recognizes then to be binding to him/her.
  • the client declares that the company will not be engaged in any of the following activities: money laundering, receiving the proceeds of drug trafficking, receiving of the proceeds of criminal activities, terrorist activities, activities under the scope of the international sanctions or any other illegal activity, and will not use Payver Limited services in any manner whatsoever that may damage the good reputation of the Payver Limited. The client declares that the information provided herein is accurate, correct and complete and the documents submitted along with this application form are genuine. The client undertakes to immediately inform Payver Limited about any changes in the above declared information in writing.

The client declares that he/she was advised and agrees to provide additional information and documents if Payver Limited requires it order to fulfilling the requirements of the Money Laundering and Terrorist Financing Prevention Act, and possible consequences for failing to comply with the obligations vested in him/her.

Title
Name, Surname
Date
City