Orange Money Aggregate Acceptor Approval form

I-IDENTIFICATION OF THE AGREGATE

Commercial name / Company name of the Aggregate Point
Surname and first name of the promoter or legal
representative
National identity card number of the promoter or legal
representative
Reference of Taxpayer's card / business license or
discharge tax
Personal telephone number (other than the one used for
OM transactions)
Location of the Promoter or Legal Representative (city,
district) *
Orange Money daughter SIM number *

II- ACTIVITY DESCRIPTION

Main activity of the Aggregated Acceptor Point *

Activity Descrition*
Location of the activity *
Trade or Business name
Minimum daily revenue amount *
Maximum amount of daily income *

III- REIMBURSEMENT OPTION

Bank to Wallet Cash Out

IV-DOCUMENTS NEEDED

National Identity Card Tax payer card or Licence

Location Plan

Name and signature of the Name and signature of the Approval of Orange Cameroun
Aggregate Service Provider the Aggregator

« By signing this form, I certify the accuracy and sincerity of the information mentioned above. »
 V-ACCEPTANCE OF ORANGE MONEY TRADE CONDITIONS

In addition, I agree to:

 Comply with all the TERMS specific to the Orange Money conditions which I acknowledge
having read.
 Respect the compliance disposition put in place by Orange Cameroon.
 Carry out transactions within the limits set by BEAC and Orange Cameroon.
 Not to undertake any activity and / or action that may directly or indirectly put at risk the interests
of Orange Cameroon.
 Use the Orange Money SIM allocated to me exclusively for Orange Money transactions.
 Not to give / hand over the daughter SIM assigned to me to any person without informing the
aggregator and Orange Cameroon.
 Immediately notify the aggregator and Orange Cameroon in the event of loss, theft or fraudulent
use by a third party of the Orange Money daughter SIM allocated to me.
 Not to develop any application with the Orange Money SIM assigned to me without the
authorization of Orange Cameroon.
 Not to use the SIM assigned to me with any equipment, hardware or software that could
constitute a threat to the security of Orange Money systems.
 Comply with the pricing conditions concluded with Orange Cameroon
 Strictly apply Orange Cameroon's pricing policy relating to operations.
 Not to use or allow the use of the service provided by Orange Cameroon for illegal purposes,
including money laundering.
 Do not participate directly or indirectly in any fraudulent transaction through the Orange money
payment system. Prohibit or immediately denounce to Orange Cameroon any fraudulent
transactions or suspected fraud.
 Authorize Orange Cameroon to debit my account for any amount fraudulently acquired following
an investigation.
 In case of requisition from law enforcement official, authorize Orange Cameroon to suspend my
account and / or debit my account for all or part of the amount of the claim.
 Authorize Orange Cameroon to suspend my Orange Money account and / or my GSM line in
the event of an investigation of fraud and / or proven fraud.
 Attend training / information sessions organized by Orange Cameroon *
 Comply strictly with user manuals and instructions and guidelines relating to Orange Money
operations.
 Give full access to Orange Cameroon, its banking service provider or any other regulator of the
financial sector for audit purposes.
 For each transaction, a service commission will be automatically deducted by Orange from the
Acceptor. This commission represents 1% including value added taxes of the amount in units
value received by the Acceptor on his account.