E-commerce Vendor Application Form

Business Details

Trading Name

Business Legal Name

Choose one of the following 

Customer Service Phone Number

Website*

Billing Descriptor and Phone Number 

Certificate of Incorporation *

Copy of Bank Statement *

Processing Currency

Director / Sole Trader Contact Details

Full Name

Phone Number

Email Address

Business Address

Street Address 1

Street Address 2

City

Country

Postal Code

Annual Turnover (£)

Annual Turnover is

Average Transaction Value

Business Owner Information

Title

Name

Date of Birth

Ownership

Scanned Identity Card, Passport or Drivers Licence

Scanned Bank proof *

Home Address

Additional Information

Agent Name

I Agree to the Experian Identify Report check for all applicants *

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