Application Form

This application form allows us to get to know you and your company/organisation better in order to give the best advise on payment solutions that fit your needs. Once the payment solution has been identified, an agreement will be signed to provide the required payment services.

* Required Fields

1. Merchant Information
Name of Merchant:*
Nature of Business:*
Description of Goods and/or Services that Credit Card payments are expected to be made for*
Registered Address:*
Correspondence Address:*

2. Contact Details
First Name*
Last Name*
Email*
Phone

(Country Code - Area Code - Phone Number)
- -

3. Website Details
Please declare all URL(s) containing merchant’s company or trading name
Primary Site URL
Secondary Site(s) URL

4. Payment Services
I am interested in signing up for
VISA/MasterCardAMEXDirect DebitNETS QROthers

5. Projected Transaction Amount
Please indicate amounts in terms of equivalent Singapore Dollars (SGD)
Minimum Amount Per Transaction (SGD)*
Maximum Amount Per Transaction (SGD)*
Average Amount Per Transaction (SGD)*
Average Monthly Volume (SGD)*

6. Transaction Limits
The default limit will be S$2,000 per transaction. Request for higher limits will be subjected to approval.
Please indicate required amounts in terms of equivalent Singapore Dollars (SGD).
Card Per Day Transaction (SGD)*
Single Transaction (SGD)*

7. Merchant's Settlement Bank Account Details (If any)
Name of Bank and Branch
Bank Account Name:
Bank Account Number:

8. ACRA Business Profile
Upload Document*

- Support PDF and .zip format. If more than 1 document please kindly zip up the files and upload in .zip format -

9. Acknowledgement
We hereby warrant that:

(1) all corporate action and approval necessary or relevant to our application herein has been duly taken or obtained and are in force.
(2) all particulars and information stated herein are true and accurate;
(3) application will be treated as confidential. (mPayment Personal Data Protection Clause)
(4) mPayment reserves the right to reject the application without assigning any reason.
 Please check to agree to the above terms.*

Please allow 7 working days for processing of application upon receiving your form.