1. Merchant Account Application Form
(Merchant ID: ）
Company Details
Business Name
Location Address
□Self Own / □Rent, Annual Rental Fee: ,Area: M2
Business
License
Registration Number
Registration Date
Registration
Location
Business Scope
Ownership
Structure
Shareholder
Capital
Contribution
Proportion
Employees Number of
Employees
CS Staffs Finance Staffs Sales staffs Technical staffs
Warehouse Address
□Self Own / □Rent, Annual Rental Fee: ,Area: M2
Stock Totally pcs/tons/pairs/boxes, Cost: USD
Contact Information
General Manager
Or CEO
ID Card Number:
Full Name Office Tel Email Fax
Resume（Start with DESC）:
MM/YY — MM/YY , ,
MM/YY — MM/YY , ,
MM/YY — MM/YY , ,
MM/YY — MM/YY , ,
MM/YY — MM/YY , ,
Customer Service Full Name Office Tel Email Fax
CS support: □By Email, □Office Hour Hotline, □24 Hours Hotline
Financial Full Name Office Tel Email Fax
Sales Full Name Office Tel Email Fax
Technical Full Name Office Tel Email Fax
Business Details

2. Product Name /
Description
Target Market □Europe □America □Japan □Asia □Other
Transaction
currency option
□USD □EURO □Other
Ticket per
Transaction
Maximum
Minimum
Average
Delivery Agent Name
URL of tracking
Recent Used
Payment Gateway
Name
Duration
Sales Information Volume Chargeback Ratio
Last Three Months
Last Six Months
Last One Year
Ratio
（%）
Visa Master
Website Details
URL
Registration Date
Server Location
Technical Contact: Tel:
Administrative Contact: Tel:
Current Anti Fraud System
□Manual Review Outbound Number:
□Anti Fraud System System Name:
□Not Available
Refund and Exchange Policy
Refund Acceptance □Yes □No □Other
Exchange Acceptance □Yes □No □Other
Merchant Bank Account Details

3. Bank Name
Full Bank Address
Account Holder’s name
Account Holder’s Full
Address
Bank Phone Number
Account Number
SWIFT or IBAN Code
ABA Routing Number
Transferred Funds
Currency
□USD □EURO □Other
Note
All fields are mandatory.
Please complete this application form in black ink by ticking (√) in the appropriate box.
DECLARATION
By filling and signing in the application form, I hereby declare that all information provided by me in
this application is true and correct.
Name
Signature
Date