NO. AND STREET NAME
CITY
COUNTRY
POSTAL CODE
CHECK HERE IF SAME AS ABOVE
NO. AND STREET NAME
CITY
COUNTRY
POSTAL CODE
(NAME TO APPEAR ON CUSTOMER STATEMENTS FOR PURCHASES. THIS DESCRIPTOR IS SUBJECT TO INTERNAL APPROVAL. ANY CHANGES WILL BE COMMUNICATED TO YOU)
(SHIPPING AND HANDLING TIME)
IF YES, PLEASE PROVIDE US WITH A COPY. REFERENCE SHOULD BE MADE TO THE COMPANY SUPPORTIVE DOCUMENTS SECTION
yes no(SHIPPING AND HANDLING TIME)
yes noIF YES, PLEASE SPECIFY
IF YES PLEASE SPECIFY IF ITS A PASS THROUGH WALLET OR STAGED WALLET
yes noPayment Method | Expected Turnover/Volume | Average Transaction Value | |
---|---|---|---|
Alipay | |||
Bancontact | |||
EPS | |||
GiroPay | |||
iDeal | |||
My Bank | |||
Payu | |||
Paysafecard | |||
Przelewy24 | |||
Qiwi | |||
Safetypay | |||
Trustly |
* note: All Settlements will be Net of any fees or charges Attach a copy of the company bank statement (dated within the last 3 months), showing the account holder name. This is required for each settlement currency bank account.
Full Name | Job Title | Date Of Birth | Country Of Residence | Nationality | Home Address | Identification No. | Company Ownership % | Are You A Director And/Or Owner? | Political Exposed Person (or related) | ||
---|---|---|---|---|---|---|---|---|---|---|---|
1 | DirectorOwner | Yes |No | |||||||||
2 | Director Owner | Yes |No | |||||||||
3 | Director Owner | Yes |No | |||||||||
4 | Director Owner | Yes |No | |||||||||
5 | Director Owner | Yes |No | |||||||||
6 | Director Owner | Yes |No | |||||||||
7 | Director Owner | Yes |No |
1. All Shareholders with 25% or more equity must be shown above.
2. If more than seven (7) principles directors and/or shareholders exist, please provide details on an additional separate sheet and attach.
3. Term ‘political exposed persons’ (“PEP”), is broad and generally includes all persons who fulfil a prominent public function and include his immediate family members or persons known to be close associates of such persons
Individual Information(Required for Shareholders and Authorised Signatory)
Photocopy of Government Identification which includes (e.g. Passport or National Identification Card)
Notice for Proof of Address: If home address is not stated on the Government Identification, proof of address is to be provided using ONE (1) of the documents below stating an individual’s name and home address. The document must also be dated within the last 3 months.
Utility Bill (NOTE: Mobile Phone Bills are not accepted)
Personal Bank Statement
Equivalent Document Issued By Central or Local Government Authority, Department or Agency
Original or certified true copy of the original(not older than 6 months) - Certificate of Incorporation (if Applicant is non UK registered)
Original or certified true copy of the original(not older than 6 months) - Memorandum & Article of Association (if Applicant is non UK registered)
Original or certified true copy of the original(not older than 6 months) - Good Standing Certificate or latest Annual Return. (if the applicant forms part of a group, the Good Standing Certificate or Annual Return of the Ultimate Parent Company, should also be provided). (if Applicant is non UK registered)
Last Audited Financial Statements validated by an external third party. (if Applicant is non UK registered)
If the applying business is a start-up and processing history is not available, please provide a detailed business plan at least 3 years, including projected volumes, projects, financials, target market and market strategies.
Group Company Structure Chart (if Applicant forms part of a group structure)
Copies of Bank Statements or Void Cheque or Deposit Slip for the settlement bank account (not older than 3 months)
Original or certified true copy of the original(not older than 6 months) - Signed Trust Deed (if Applicant is a trustee of a trust)
Original or certified true copy of the original(not older than 6 months) - Of any applicable License ( e.g Financial; Payment; E-Money, Gaming or Investment Institutions) (if Applicant is non UK registered)
A List of Affiliates / white-labels ( if applicable)
Original or Certified True Copy of the original - Distribution Agreement. Not older than 2 years and signed by the current Directors. (e.g Digital Media or any other type authorised reseller)
Card Processing Statement from current provider (if there are any indications of elevated chargeback ratios, please provide an explanation as well as a chargeback remediation plan)
Product/Service provision terms & conditions must be provided (applicable to Beta Websites)
Latest AML, Fraud & Chargebacks Policies and Procedures (upon request by SecureTrading)
Any other document that might be relevant to this application
ADDITIONAL DOCUMENTATION TO THE ABOVE MAY BE REQUIRED DURING THE APPLICATION PROCESS AND/OR FOLLOWING APPROVAL. IF DOCUMENTATION IS NOT PROVIDED IN ENGLISH, YOU MAY BE REQUIRED TO HAVE THE DOCUMENTATION TRANSLATED, AUTHENTICATED, NOTIRISED OR OTHERWISE.
IF THE ABOVE REQUESTED DOCUMENTS ARE NOT AVAILABLE IN ORIGINAL, CERTIFIED COPY OF THE ORIGINAL DOCUMENT AUTHENTICATED BY A NOTARY PUBLIC, ATTORNEY, PUBLIC ACCOUNTANT, TO BE A TRUE COPY OF ORIGINAL DOCUMENT IS REQUIRED.
The Payment Card Industry Data Security Standard (PCI DSS) is a compliance requirement for merchants to enable safe payment transactions and ensure cardholder data is stored securely. Merchants that store cardholder data must be PCI DSS compliant or assume full liability for (i) cardholder losses caused by data theft, and (ii) any fines imposed by card schemes. More information can be found on https://www.pcisecuritystandards.org/pci_security/
PCI DSS is based on the total number of yearly credit card transactions processed.
Check one | PCI Level | Total Yearly Credit Card Transactions |
Redirect | IFRAME | Direct Post | JavaScript | XML | Anything Else | |
---|---|---|---|---|---|---|---|---|---|
1 | Over 6 Million | RoCA | RoCA | RoCAEP | RoCAEP | RoC | RoC | ||
2 | 1-6 Million | SAQ A | SAQ A | SAQ A - EP | SAQ A - EP | SAQD | SAQD | ||
3 | 20,000 - 1 Million | SAQ A | SAQ A | SAQ A - EP | SAQ A - EP | SAQD | SAQD | ||
4 | Under 20,000 | SAQ A | SAQ A | SAQ A - EP | SAQ A - EP | SAQD | SAQD |
Check if you are already PCI DSS compliant. A copy of your PCI DSS Certification, Self-Assessment Questionnaire and latest ASV scan must be provided.
Check if you would like to make use of STFS Portal for completing your PCI Self-Assessment Questionnaire. (Please note, fees apply to this service and will be agreed as part of your contract).
By signing below and submitting this Application Form you acknowledge and agree:
a) You are applying for merchant acquiring services from SecureTrading Financial Services Limited (“STFS”);
b) You are authorised to submit this Application Form and all accompanying information;
c) It is within STFS’s discretion to approve or decline this application. STFS may decline this application without reason. If this application is approved, you will be required to enter an agreement for the provision of services and this Application Form will form part of the agreement;
d) All information provided as part of this Application Form (whether on this form or by other means) is true and correct. You may be required to provide further information. If there is any delay in providing any required information, STFS may not be able to approve your application. You will notify STFS if there is any material change in any information provided;
e) STFS is not liable for any loss incurred by you as a result of any action of STFS which either delays provision of the service to you, or results in your application being declined, when such actions are required by STFS to comply with its obligations under applicable laws and/or its internal policies and procedures;
f) You authorise STFS and its agents to perform credit checks, and any other checks as reasonably necessary, and exchange information obtained in such checks with third parties as reasonably required, to (i) assess this application and verify any information provided, (ii) manage provision of the services to you, and (iii) review your financial standing on a periodic basis; and
g) You are bound by the privacy policy which describes the handling of any personal data, including direct marketing. STFS is a subsidiary of UC Group Limited and STFS may exchange personal data with other companies in the UC Group as well as UC Group service providers. You can change your marketing preferences by calling +44 (0) 203 764 5050 or emailing dpofficer@securetradingfs.com.
Please print this form, complete and sign the declaration and send it to