CONFIDENTIAL DOCUMENT
MERCHANT APPLICATION FORM
Merchant Details:
S.NO.
Particular
Detail (To be filled by the Merchant)
Merchant Details
1
Merchant Legal Name*
2
Merchant Doing Business as Name*
3
Merchant Address (where its
Business is conducted (“Premises”)*
4
Entity Type (Constitution of the
Merchant Establishment)*
(Proprietorship/Partnership/Private
Limited/LLP)
5
Date of Incorporation
(dd/mm/yyyy)*
6
CIN* (for PVT LTD and LLP)
7
GST No *
8
PAN No.*
9
Nature of Business (in Details) *
10
Merchant Portal (Web Site URL) *
11
Company Turnover (Last FY)
Contact Details
12
Managing Director/Owner Name*
13
Date of Birth *
14
PAN Number *
15
DIN* (if Pvt Ltd or LLP)
16
Residential Address *
CONFIDENTIAL DOCUMENT
17
Aadhaar*
18
Mobile No. *
19
Email Address *
20
Technical POC Name
21
Contact Number
22
Email Address
23
Email IDs authorized to
send/receive settlement files and
communicate customer complaints/
reversals/escalations*
Bank Account Details
24
Bank Name*
25
Account Number*
26
IFSC Code*
27
Branch Address*
SERVICES REQUIRED (Please tick your answer):
PayIN*: YES / NO
PayOUT*: YES / NO
(If opted NO, the settlement of PayIN shall be done in the bank details provided above)
Purpose of services*:
__________________________
For Merchant:
Authorised Signatory Signatures: _____________________________
Authorised Signatory Name:
CONFIDENTIAL DOCUMENT
Merchant Seal:
MANDATORY LIST OF DOCUMENTS TO BE REQUIRED FOR ONBOARDING PURPOSE
FROM THE MERCHANT*
Document Name for Private Limited
To be Signed by
1. Articles of Association (AOA)
Signed by any one Authorised
Signatory
2. Memorandum of Association (MOA)
Signed by any one Authorised
Signatory
3. Board resolution (Sample Attached)
Signed by two Authorised
Signatory
4. List of Directors from MCA (Sample Attached)
Signed by any one Authorised
Signatory
5. Certification of Incorporation (COI)
Signed by any one Authorised
Signatory
6. PAN of the Company.
Signed by any one Authorised
Signatory
7. GST Registration Certificate
Signed by any one Authorised
Signatory
8. Undertaking of product/services to be sold (Sample
Attached)
Signed by any one Authorised
Signatory
9. Current Address proof of the Company (Bank
Statement/Utility Bill/Rent Agreement)
Signed by any one Authorised
Signatory
10. KYC of all Director's (Aadhar Card, Pan card,
Passport/DL/Voter Card)
Self-Attested
11. Service Agreement shall be signed printed on stamp Value
Rs. 300/-
Signed by any one Authorised
Signatory
12. Cancellation Cheque (in which account fund to be settled)
13. Legal Opinion from an Licensed Lawyer
Document Name for Partnership Deed
1. Partnership Deed
2. PAN of the Firm.
3. GST Registration Certificate
4. Undertaking of product/services to be sold (Sample
Attached)
5. Current Address proof of the Firm (Bank Statement/Utility
Bill/Rent Agreement)
6. KYC of all Partner's (Aadhar Card, Pan card,
Passport/DL/Voter Card)
CONFIDENTIAL DOCUMENT
7. Service Agreement shall be signed printed on stamp Value Rs.
300/-
8. Cancellation Cheque (in which account fund to be settled)
Document Name for Proprietorship
To be Signed by
1. Shop Establishment Certificate / MSME Registration Certificate/
Trade License etc
Signed by
Proprietor
2. GST Registration Certificate
Signed by
Proprietor
3. Undertaking of product/services to be sold (Sample Attached)
Signed by
Proprietor
4. Current Address proof of business Address (Bank Statement/Utility
Bill/Rent Agreement)
Signed by
Proprietor
5. KYC of Proprietor (Aadhar Card, Pan card, Passport/DL/Voter Card)
Signed by
Proprietor
6. Service Agreement shall be signed printed on stamp Value Rs. 300/-
Signed by
Proprietor
7. Cancellation Cheque (in which account fund to be settled)
8. Last 3 Month's Current account Bank statement
Signed by
Proprietor