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Infinpay Merchant Registration Forms
Business Registration Details
Business registered name
Business registration No.
Registered business address
Business type
.
Sole Proprietary
.
Partnership
.
Corporation
.
Non-Profit Org
.
Others
URL
No. of years in business
Department Contact Details
*Name
Designation
*Email
*Phone
*Name
Designation
*Email
*Phone
*Name
Designation
*Email
*Phone
*Name
Designation
*Email
*Phone
Business Information
Type of products/services
Industry
Shipment/Fulfilment Period
Total business volume (MYR)
Average ticket size (MYR)
Projected volume in e-commerce (MYR)
Shopping Cart
Total volume of Refund in percentage (%) over the Total Sales Volume
Total count of Refund in percentage (%) over the total Sales Count
Total volume of Chargeback in percentage (%) over the total Sales Volume
Total count of Chargeback in percentage (%) over the total Sales Count
Bank Account Information (Settlement Bank)
Bank Name
Bank Account Name
Bank Account No
Bank Account Name
Bank Branch Address
I hereby declare that all information furnished herein is true and complete to my knowledge. I agree to be bound by the Merchant’s Agreement.
I further acknowledge and confirm that I have carefully read the provisions of the Merchant Agreement which are attached to this Form and have understood them and have not relied upon any statement, representation or waiver made by Infinitium Infuture Sdn Bhd. Other than that, set out in the Merchant Agreement. I hereby irrevocably and unconditionally agree to observe, fulfil, and comply with the provisions of the Merchant Agreement.
Signature
gif,jpg,jpeg,png,psd,tif,tiff
*Authorized Person Name
Signing Date
Submit