Agent Name
Acquirer Name
—Please choose an option—ElavonWorldpay
Owner Full Name
Home Address
Business Name
Business Address
Mobile Number
Reg Number(if LTD)
Business Type
—Please choose an option—LTDSole TraderPartnershipCharity
Sales Activity Notes
Face to Face
—Please choose an option—TenTwentyThirtyFortyFiftySixtySeventyEightyNinetyHundred
CNP(Customer Not Present)
Card Payment
—Please choose an option—NewSwitcher
Debit Card Rates
Credit Card Rates
Commercial Rates
Days Transaction
—Please choose an option—Same Day1/7 Days8/14 Days
ATV ( Avg Transaction Value)
Terminal Type
—Please choose an option—A920CastleDX8000IngenicoS1F2 CastleEcommercePay by LinkVirtual Terminal
Annual Card Turn Over
American Express
—Please choose an option—YesNo
Rental Including Sim ( wifi and Gprs)
Gratuity
Numbers of Terminal
Business Logo
Cash Back
Tips
Bank Name
—Please choose an option—BarclaysLloydsNatwestHSBCSantanderZemplerMonzoAnnaMetroSterlingIrelandScotlandWiseRevoultNationwideETCTideUpOthers
Account Holder Name
Sort Code
Account Number
Any Notes
KYC(Know Your Customer)
—Please choose an option—PassportDriving License
KYB(Know Your Bank)
—Please choose an option—Bank StatementBank Screenshot
Site Pictures
Inside Shop
Front of Shop