Merchant Registration Form

Merchant Name : .PUTRA SIREGAR MERAKYAT

Owner Name : .SLAMET RIYADI
Merchant Email : .putrasiregar.bali@gmail.com
Merchant Address : .jl. Raya Condet No.1, RT.4/RW.1, Balekambang, Kec.
Kramat jati, Kota Jakarta Timur, Daerah Khusus Ibukota Jakarta 13530
.
Phone Number : .085889406051
Website /Social Media : .www.psstore.id
Marketplace Store : .Bukalapak, Shopee, Tokopedia (PSstore)
Business Category : Retail.
Type of Product : Gadget
Average Value per Transaction : .Rp. 1.500.000
Daily Number of Transactions : .50-100.

Account Details :
Bank Name : Mandiri
Branch : Jakarta Tanjung Priok...........................................................
Bank Branch Address : .Jakarta...........................................................................................
Account’s Number : .1200011678492
Account’s Name : Slamet Riyadi.
*Choose one of the bank lists
 This Account number will be used for settlement of the transactions.

Requested Payment Method:

Payment Method Sub Payment Method Price per Transaction Requested
(Yes/No)
Mandiri Rp. 4.000 yes
Virtual Account BNI Rp. 4.000 yes
BRI Rp. 4.000 yes
Permata Rp. 4.000 yes
Dana 1,5% yes
E-Wallet OVO 1,5%
LinkAja 1,5%
Debit/Credit Card Visa, Master Card 2,9% yes
Here with agrees to declare the following things: 
 
1. Merchant agree and will comply all terms and conditions stated in Durianpay website
(http://durianpay.id/tnc ).
2. Merchant has read and understood our Privacy policy stated in Durianpay website
(http://durianpay.id/privacy-policy)

 
Jakarta..., 7 April 2021
(Putra Siregar Merakyat)
a.n

Slamet Riyadi
Head of Distributor Area