Merchant Application Form

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How long have you been banking with us?

Years

Months

Account Number

Type of Business

Merchant Name (DBA or trade name)

Legal name

Address

Neighborhood

Years at this location

Business telephone number

Mobile Number

City

E-mail Address

Chamber of commerce number

Business hours

Visible name Display at location

Type of business and merchant or services sold (E.g. Clothing)

Name (owner/director)

Identification number

Telephone number

Principals address

Place of Birth

Please provide link to your KVK (Chamber of Commerce) here

Only PDF and Image formats are allowed

Please upload a copy of your ID here

Only PDF and Image formats are allowed