E-WALLET MERCHANT APPLICATION

the ASEAN payment people (BSN/PY e-Wallet Tag-on Form)

MERCHANT DETAILS BANK MID : BANK TID :

Business Reg.
Business Reg. No:
Name :
Registered
Address :
Nature of
Trading Name :
Business / MCC :
Trading
Address :
Contact Person Contact
Name: Number(s):

Designation : Email Address :

Settlement Settlement Bank

Bank Name : Account No:

PRODUCTS ACCEPTANCE

PRODUCTS MDR PRODUCTS MDR SETTLEMENT

Single
Touch n' Go WeChat Pay (Cross Border)
Settlement
Consolidated
Boost WeChat Pay (Local)
Settlement

Alipay UnionPay

GrabPay

DECLARATION

By signing this E-Wallet Merchant Application, the Merchant:

A. Certify that all information provided in this E-Wallet Merchant Application is true and accurate.
B. Understand that GHL Cardpay Sdn Bhd reserves the right to approve or decline this application as GHL Cardpay Sdn Bhd deem fit without giving any
reason.
C. Accept and agree to be bound by the E-Wallet Merchant Services Terms & Conditions (including any amendments, settlement and additions made at
any time and from time to time by GHL Cardpay Sdn Bhd in accordance with the terms therein) as per attached in Appendix 1.
D. For Paysys obligation kindly refer to the SLA as per attached in Appendix 2.
E. Please provide latest 1st page of the bank statement.

Merchant's Authorised Signatory Merchant's Company Stamp: Verified by :

Name : Name :
NRIC No : Date:
Designation :
Date :
Comments / Recommendations by Sales Person:

PAYSYS Customer Care No : 603 - 9200 8001 Fax No : 603 - 9200 7420 Email address : bsnmah@paysys.com.my