CHANNEL PARTNERSHIP SLOT

RESERVATION FORM AND CONTRACT

APPLICANT DETAILS
Applicant's Full Name: [Insert Full Name]
Applicant's Legal Entity (if applicable): [Insert Legal Entity Name]
Business Address: [Insert Business Address]
Contact Number: [Insert Contact Number]
Email Address: [Insert Email Address]

RESERVATIONS
Preferred Location(s) for Channel Partnership:
1. [Insert State/District/Area/ PIN]
2. [Insert State/District/Area/ PIN]
3. [Insert State/District/Area/ PIN]

PAYMENTS
Total Investment Amount (INR): [Insert Investment Amount]
Reservation Deposit Amount (INR): [Insert Deposit Amount]
Balance Amount (INR): [Insert Balance Amount]
Expected Date of Balance Payment: [Insert Date]

PAYMENT AND RESERVATION TERMS

● The aforementioned Reservation Deposit Amount is due upon receipt of the invoice or
upon signing this Reservation Form.
● Your signed Reservation Form confirms your intention to accept our offer and become
our Channel Partner.
● Upon the successful receipt of the Reservation Deposit Amount, your Channel Partner
Slot(s) will be confirmed.
● Cheques/Drafts should be made payable to XPayBack Pvt Ltd.
● Payments by Bank Transfers are preferred. Details will be listed on the invoice.
ACKNOWLEDGEMENT AND SIGNATURE
● We hereby confirm our reservation of the Channel Partnership in the locations listed
herein above and accept the terms and conditions attached hereto, which are an integral
part of this Reservation Contract.
● We acknowledge that this reservation form, along with the attached terms and
conditions, constitutes our agreement with XPayBack Pvt Ltd. By signing this reservation
form, we confirm that we have reviewed and comprehended both the reservation form
and the attached terms and conditions. We acknowledge our agreement to abide by the
terms outlined herein.
● The signatory of this reservation form and contract hereby states that he/she is duly
authorised to represent the individual or entity reserving the designated Channel
Partnership slots. The signatory affirms that he/she possesses full power and authority
to legally bind the said individual or entity to this agreement.

For and on behalf of [insert applicant’s name]

[signatory name]
[signatory title, if applicable]
[signatory company name, if applicable]
[place]
[date]