Please complete this section for the company applying for the merchant account.
3. Country of incorporation Select country Austria Belgium Bulgaria Croatia Republic of Cyprus Czech Republic Denmark Estonia Finland France Germany Greece Hungary Iceland Ireland Italy Latvia Lithuania Luxembourg Malta Netherlands Poland Portugal Romania Slovakia Slovenia Spain Sweden United Kingdom Norway
1. Detailed description of products/services sold Please explain the business model.
2. Website(s) / URL(s) (separated by comma)
10. What is the delivery time for goods/services, upon purchase? Total should equal 100%.
13. Please provide 6 months of the most recent processing history below. History should clearly show transactions, chargebacks and refunds per month. Specify the applicable currency for the volumes below
14. What is the origin of transactions? Where do cardholders come from; total should equal 100%.
1EEA member countries: The EEA countries are Austria, Belgium, Bulgaria, Croatia, Republic of Cyprus, Czech Republic, Denmark, Estonia, Finland, France,
Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland,Portugal, Romania, Slovakia, Slovenia, Spain, Sweden and the UK.
2CIS: The Commonwealth of Independent States are Armenia, Belarus, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan
3USA: The United States of America
1. Describe all security measures and fraud/chargeback handling E.g.: Do you verify customers’ identities? How is access to customers’ accounts being secured? Do you have a chargeback analysis process in place? Do you have anti-fraud procedures in place? Is a negative cardholder database (record of cards that have fraud/chargeback or negative history and all transactions are checked against it) maintained? Do you have velocity controls (limitation of the number of times the credit card can be used in a given day/week/month, or a limitation on the amount spent) in place?
2. Do you process secure transactions? If yes, how is the percentage split? If no, please proceed to section E.
1. Please indicate the desired processing currency(ies) The currency(ies) in which your products/services are sold. AED AMD ARS AUD BDT BGN BOB BRL BYN CAD CHF CNY CZK DKK EUR GBP GEL GGP GIP HKD HRK HUF IDR ILS INR JPY KRW KZT LYD MDL MXN NGN NOK NZD PLN RON RUB SAR SEK SGD THB TRY TWD UAH USD ZAR Please note that the settlements to the ConnectPay IBAN account will be in EURO only.
General contact (primary)
Proof of address
Proof of address required for every beneficial owner owning >25% of the company: such as internet, electricity, water and gas bills or bank statement, not older than 3 months
Soft copy via email only
Please note that ConnectPay reserves the right to ask for additional documentation at its discretion in order to satisfy its regulatory obligations. Additional requirements may apply for certain applications, regions, business types, and so on.
Website/URL checks are performed to ensure that any processing URL is compliant with card scheme best practices. The following items must be present on the entire website and specifically on the payment page and purchase process:
The legal name and registered address of the applying company should be clearly visible on the website, e.g. Terms and conditions and/or ‘Contact us’ section and/or the footer of the website
Terms and conditions
Should be clearly described on the website and accepted when opening an account and/or during checkout
Should be clearly visible on the website before or during checkout
Proof of domain ownership
The applying company or the UBO must own the domain. The owner of the domain (registrant) should be visible on Who is. If this is not the case, please provide an invoice from the hosting company confirming ownership of the respective URL/s
“Billed as” descriptor
Must be clearly displayed during the checkout process
Data protection and declaration
In relation to the GDPR (General Data Protection Regulation) and other applicable legal acts ConnectPay will process the data provided in this online application and any other data which you subsequently give to us in any manner in order to fulfill the agreements between customer and ConnectPay, for the following purposes:
To provide, develop or improve our products and services, or otherwise for legitimate business reasons;
For internal assessment and analysis (e.g. automated profiling, market and product analysis);
If we are under a duty to disclose or share your data to comply with any legal or regulatory obligation; or to protect our rights, property, or safety of our employees, customers, or others. This includes exchanging information with other companies and organizations for the purposes of fraud protection.
Please note that your personal data may, for the above purposes, also be disclosed to, or shared with, other entities in the ConnectPay group of companies, and other third parties entrusted with providing ConnectPay with due diligence, software development and maintenance, and payment processing services.
From time to time, we would like to inform you (by post, telephone, fax, e-mail or other electronic means) about our future products and services.
ConnectPay respects your privacy and will not share your personal data with third parties for marketing purpose.
For more information please refer to our
Please ensure that your application form and supporting documentation is complete and correct.
By submitting this form, you confirm that all information provided is accurate and truthful and you consent to credit and information verification checks being performed.