MERCHANT EVALUATION CHECKLIST (MEC)

Date Submitted : _______________ Name of MSE: __________________

Site Visitation : YES NO Referral ID : ____________________

If NO, please specify reason: _____________________________________________________

1. CHANNELS (Tick whichever is applicable)

Please Specify acquiring for which Bank: ________________ Type : ( ESA/TPA/Others)

Blitzes MPAY Leads Online Application(MPAY) Others (pls specific:_________)

Bank Leads (i) Preferred Branch :

(Compulsory ) (ii) Staff Name :
(iii) Staff No :
(iv) Reference No :

Type of Application : New Existing Paid Amount : _____________________

Type of Product : MPOS Android IOS No of Units (Android/iOS)

EDCPOS Dial Up No of Units (EDCPOS)

IP
GPRS

IPG Premium Enterprise

Others Pls specific: (______________________ )

2. PRINCIPAL INFORMATION (KYC)

(a) Registered Name :_______________________________
(b) Trading Name : MPY*_____________________________________ ( limit to 25 char ) Office Building
(c) Nature of Business :_______________________________
Shop Houses
(d) Business/Premise Address (pls stamp below)
(e ) Operating Premises SOHO

Warehouse/Factory

Home Based

> 2 Years
(f) Tenure of Business
< 2 Years
*(Please provide reason if address on company stamp differs from trading address)

3. POINTS OF CONTACTS

(a) Name of Person In Charge (PIC): ______________________________
(b) Designation: __________________________________
(c ) Mobile No: ___________________________________
(d) DID: _________________________________________
(e) Email (if any): ________________________________
(f) Fax No: _______________________________________
Detail PIC for IT Configuration (IPG Package Only)
(a) Name of Person In Charge (PIC): _________________
(b) Contact No: ___________________________________
(c) Email : _________________________________

4. COMPANY STATUS
Sole Proprietor Partnership Sdn Bhd Association PLC

MNC GLC Global MNCC Berhad LLP

Professional Body (eg: Law Firms, clinics ) JMB/JMC

* Note : Provide company profile (if any)

5. QUALIFYING CATEGORY (Tick whichever is applicable)

Acquiring Bank & Forms Required

Schedule 1 (MPOS/EDCPOS) Schedule 1 (MPOS/EDCPOS)

Letter of Offer (MPOS/EDCPOS) Letter of Offer (MPOS/EDCPOS)
Mpay Sponsored Merchant Application Form (Ver 1.2) Merchant Checklist Application Required (Maybank)
MBB (TPA) Guarantee & Indemnity MBB (ESA) Merchant Application Form (Maybank)
Terminal Rental Agreement (MPOS/EDCPOS) Merchant Register Name (Maybank)
OCBC or MBB Direct Debit Form Letter of Offer for Maybank Merchant Service (MBB)
Opt Out Form Merchant Business Cards Business Group (MBB)
Activation Form (MBB)
OCBC or MBB Direct Debit Form
Opt Out Form

Schedule 1 (MPOS/ EDCPOS)

Letter of Offer (MPOS/ EDCPOS) Letter of Offer (EDCPOS)
Mpay Sponsored Merchant Application Form (Ver 1.3) Schedule 1(Synergy)
BI (TPA) Mpay Sponsored Merchant Agreement SYNERGY Mpay Sponsored Merchant Agreement (Synergy)
Terminal Rental Agreement (MPOS/ EDCPOS) Terminal Rental Agreement
Checklist - "Stop the Double Swipe" OCBC or MBB Direct Debit Form
OCBC or MBB Direct Debit Form

Schedule 1 (IPG)
Letter of Offer (IPG)
BI (IPG) Mpay Sponsored Merchant Application Form (Ver 1.3) OCBC (TBC)
Mpay Sponsored Merchant Agreement
OCBC or MBB Direct Debit Form
Website Requirements that includes refund, shipping &
privacy policy
*Note : for IPG Package : Terminal rental Agg & Checklist "Stop the Double Swipe" not required.

Supporting Document Required

Sole Proprieter / Partnership / LLP Sdn Bhd / Berhad

NRIC of Sole Proprieter & All Partners NRIC/Passport of Director (Authorised Signatory)
Borang D/E : Business Registration M & A (Memorandum an articles of assocation)
Borang A/B : Updated subsequent page Form 8/9/13
Latest 3 Month Bank Statement Form 24 (complete share)
Business License (BNM requirement) Form 49
Exterior & Interior Photo (min: 6 angles) Companies Act 2016 (Section 14, 15, 58, 23b)
Price List / Product Brochure Board Resolution (if director appoint any others authorised signatory
Form 32A (if they have share transfer form old owner)
Association Latest 3 Month Bank Statement
Business License (BNM requirement)
NRIC of Chairman Exterior & Interior Photo (min: 6 angles)
NRIC of Treasurer Price List / Product Brochure
NRIC of Secretary/Appointed PIC as per Board Resolution
Association Registration Certificate
Minutes of Latest AGM with list appointed committee members
Board Resolution
Organization Chart
Latest 3 Month Bank Statement
Business License (BNM requirement)
Exterior & Interior Photo (min: 6 angles)
Price List / Product Brochure

Additional Document Required

Akta Jualan Langsung (AJL) : MLM Companies

Akta Industri Pelancongan (Borang 2) : Travel Agency License
Akta Kemudahan (Borang B), Akta Perubatan (Borang 12), Perakuan Pendaftaran Penuh (Borang 10) & Surgery (Borang F) : Clinic
Akta Pergigian 1971 (Borang 7), Akta Kemudahan dan Perkhidmatan Swasta (Borang C) & Perakuan Amalan Tahunan (Borang 9) : Dental
Perakuan Amalan Tahunan : Veterinary Clinic
Pharmacist's Poisons License (Poisons Act) : Pharmacy
Real Estate License : Real Estate Agencies
Registration of tourist accomodation premise : Tourist Accomodation Premises i.e. hotels, budget hotels, hostels
Practising Certificate of owner/partner : Law Firm
Audit License of owner/ partner : Audit Firm
For Construction Related Companies/Businesses (including contractors) : CIDB License
Letter Of Offer by Franchisor : Franchieses
For Companies/ Business related in name to associations (proof of members from associations)
Money Services Business Act : Money Changer/ MoneyLender
Letter from principal if the principal brand name is used as trading name exp: Maxis

Note : All original documents must be sighted by the Sales Executive to confirm the authenticity of the above supporting documents.
All copies of the supporting documents must be duly stamped ‘Sighted and Verified’ and acknowledged by the Sales Executive concerned.
6. ACKNOWLEDGMENT
I, hereby acknowledge and confirmed the physical site visit of the abovementioned merchant was conducted thoroughly.
All this information furnished are accurate and true, including the photographs.
I have explained the Letter of Offer & Sponsored Merchant Agreement Terms and Conditions to the Merchant.
I have sighted the original copy of the document submitted as supports documents enclosed.
I have visited the Merchant at the Merchant's principal place of business and captured photograph of the premises and signboard.

SIGNATURE REMARKS
SALES PERSON/ AGENT

Name:
Referral ID:
IC No:
Date :

7. REMARKS BY TEAM MANAGER/ HEAD OF MERCHANT/ GM/CEO- CARDS & ACQUIRING

For Sales Admin & Operation Acknowledgment

Received & Checked By : Received & Acknowledged By :

(Sales Admin) (Operation Team)

…………………………………………………………………………… ……………………………………………………………………………………..
Name : Name :
Date : Date :
Time : Time :