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JURISDICTION
Europe
USA
Columbia
Mexico
ABOUT US
FAQ
FEES
MasterCard
Visa Card
Pagaflex Card
Bank Transfers
SUPPORT
REGISTER
reg-test
2020-02-29T12:36:48+01:00
1
Jurisdiction
2
General Informations
3
Product
4
Contact Details
Jurisdiction
*
Please select
Europe
Columbia
Mexico
Please select the jurisdiction for which you are seeking payout services for.
Europe
Prepaid & Virtual Cards and Bank Transfers
Columbia
Bank Transfers
Mexico
Prepaid Card and Bank Transfers
Company Type
*
Please select
PLC
Limited
Partnership
Sole Trader
Charity
Full Company Name
*
Co. / Charity Reg. No.
*
VAT Reg. No.
Registered office address in country of incorporation
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Austria
Belgium
Bulgaria
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Netherlands
Norway
Poland
Portugal
Republic of Cyprus
Romania
Slovakia
Slovenia
Spain
Sweden
UK
Country (Distribution only to SEPA registered jurisdictions / EEA)
Registered office address in country of incorporation
*
Street Address
Address Line 2
City
Amazonas
Antioquia
Arauca
Atlántico
Bolívar
Boyacá
Caldas
Caquetá
Casanare
Cauca
Cesar
Chocó
Córdoba
Cundinamarca
Distrito Capital de Bogotá
Guainía
Guaviare
Huila
La Guajira
Magdalena
Meta
Nariño
Norte de Santander
Putumayo
Quindío
Risaralda
San Andrés, Providencia y Santa Catalina
Santander
Sucre
Tolima
Valle del Cauca
Vaupés
Vichada
Estado
CEP
Registered office address in country of incorporation
*
Street Address
Address Line 2
City
Aguascalientes
Baja California
Baja California Sur
Campeche
Ciudad de México
Chiapas
Chihuahua
Coahuila de Zaragoza
Colima
Durango
Guanajuato
Guerrero
Hidalgo
Jalisco
México
Michoacán de Ocampo
Morelos
Nayarit
Nuevo León
Oaxaca
Puebla External
Querétaro Arteaga
Quintana Roo
San Luis Potosí
Sinaloa
Sonora
Tabasco
Tamaulipas
Tlaxcala
Veracruz
Yucatán
Zacatecas
Estado
CEP
Use different business address
Use different business address
Business address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Austria
Belgium
Bulgaria
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Netherlands
Norway
Poland
Portugal
Republic of Cyprus
Romania
Slovakia
Slovenia
Spain
Sweden
UK
Country
Business address
*
Street Address
Address Line 2
City
Amazonas
Antioquia
Arauca
Atlántico
Bolívar
Boyacá
Caldas
Caquetá
Casanare
Cauca
Cesar
Chocó
Córdoba
Cundinamarca
Distrito Capital de Bogotá
Guainía
Guaviare
Huila
La Guajira
Magdalena
Meta
Nariño
Norte de Santander
Putumayo
Quindío
Risaralda
San Andrés, Providencia y Santa Catalina
Santander
Sucre
Tolima
Valle del Cauca
Vaupés
Vichada
Estado
CEP
Business address
*
Street Address
Address Line 2
City
Aguascalientes
Baja California
Baja California Sur
Campeche
Ciudad de México
Chiapas
Chihuahua
Coahuila de Zaragoza
Colima
Durango
Guanajuato
Guerrero
Hidalgo
Jalisco
México
Michoacán de Ocampo
Morelos
Nayarit
Nuevo León
Oaxaca
Puebla External
Querétaro Arteaga
Quintana Roo
San Luis Potosí
Sinaloa
Sonora
Tabasco
Tamaulipas
Tlaxcala
Veracruz
Yucatán
Zacatecas
Estado
CEP
Type of Business (general description)
*
Website
Please select a product
Product
*
Prepaid Cards
Bank Transfers
Product 2
*
Prepaid Cards
Virtual Cards
Bank Transfers
Bank Transfers
What do you foresee as the main usage of Bank Transfers
*
Projected monthly total amount of Payouts
Projected Payout transaction count per month
Transactions divided between accountholders for the following countries
Germany (%)
France (%)
Netherlands (%)
Italy (%)
Spain (%)
Portugal (%)
Austria (%)
Others (%)
Prepaid Card
What do you foresee as the main usage of the cards
*
Number of required cards
*
Please select
0-50
50-100
100-500
500-1000
1000-5000
5000+
Required Currencies
*
EUR
GBP
USD
Primary Contact
Title
*
Please select
Mr.
Mrs.
Dr.
Rev.
Prof.
Name
*
First
Last
Email
*
Phone
*
Finance Contact (optional)
Title
Please select
Mr.
Mrs.
Dr.
Rev.
Prof.
Name
First
Last
Email
Phone
Operational Contact (optional)
Title
Please select
Mr.
Mrs.
Dr.
Rev.
Prof.
Name
First
Last
Email
Phone
Privacy
*
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Phone
This field is for validation purposes and should be left unchanged.