Paylink Payment Gateway Application Form
Kindly follow the 3 simple steps below for the payment gateway application:
1.) Fill up the Merchant Registration Information first and print out for signature and company stamp.
2.) Prepare the documents as checklist below to upload.
3.) Submit the form and check with out support team or email us at: sales@pay-link.net
Documents Checklist to upload

Applicant's IC / Passport Bank Statement Form 9 Form 24 Form 49 Form 13 M&A Business License Payment Slip Merchant Registration Information (with signature and chop) Others (business related doc)
Merchant Registration Information
Registered Company Name*
Company Registration No.*
Web URL
Phone Number*
Company E-mail*

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Type of Company*

Private Limited (Sdn Bhd) Berhad Sole Proprietor Partnership
Year in Business*
Months in Business*
Business Trading Name
Type of Business*

Membership Dealership MLM Franchise Chain Retails Wholesale Shop Others (Pls email us more details)
Product / Services offered (Describe in Details)*
Estimated sales per transaction*
Estimated monthly sales volume*
Applicant / Contact Person
Contact Person*
First Name Last Name
Title*

Owner Director Manager / Supervisor
Phone Number*
E-mail*
Merchant Bank Information (Settlement Account)
Bank Name*
Account No*
Account Holder Name*
Opening Bank Location*
Declaration
This declaration is made together with the date of this application*

I / We hereby wish to apply for Paylink Payment Gateway services. I / We confirm that I / We shall be subject to the terms and condition governing the use of above service and hereby warrant that the above information is complete and accurate. I / We have read, understand and be bound to all clauses stated in the Merchant Agreement as spelled out and published at www.pay-link.net/library/agreement/Paylink-MYR-Merchant-Addendum.pdf and acknowledge that these clauses may be modified by Paylink from time to time. I shall always keep myself updated on any modified clauses by visiting the above URL. I / We fully understand that Paylink Solution reserves the right to decline this application without any reason. The form submition warrants that he / she has the full capacity and authority to sign and submit this application. I / We fully understand that if the applicant's sites found to be selling banned/illegal products or services later are subject to immediate account termination, frozen funds, forfeiture of funds, fines, and/or order cancellations, all without notice.
Date of Application
Merchant Chop & Sign:

_______________________________

Name:

IC/Passport No:

Title:

Tel:

Email:
Witness by:

_______________________________

Name:

IC/Passport No:

Relationship to Merchant:

Tel:

Email:
Please click Print Form for signature and chop , and then upload it at the next page.

If you fill the form before, please go to www.pay-link.net/checklist.asp for documents upload.

E 111, Block E, Phileo Damansara 1, No 9, Jalan 16/11, Off Jalan Damansara, 46350 Petaling Jaya, Selangor, Malaysia. Tel : +603 - 7731 9333 Email: sales@pay-link.net Website: www.pay-link.net

Service Application Checklist

(scan and upload the documents or email us at sales@pay-link.net later)
Applicant's IC / Passport copy*
Company's Bank Statement (latest 3 months)
for new bank account, just provide one month bank statement
Form 9
Form 24
Form 49
Form 13 (if any)
M&A
Business License (for MLM; Healthcare Product; others that required)
Payment slip for Paylink Gateway Application
check with us for online payment or you can submit the application form first
Merchant Registration Information (with signature and chop)
Others (business related doc)
Paylink Services / Products Apply (Leave it blank if not sure)

WebPOS EzyPAY WapPOS WebATM Others (Pls email us more details)
Introducer (if any)

(can inform us later before we open the merchant account)
Introducer Name
Introducer Company No / IC number
Introducer Merchant ID
Please click submit form to submit the documents to Paylink Solutions. Or you can email / courier us the documents as per contacts below:

E 111, Block E, Phileo Damansara 1, No 9, Jalan 16/11, Off Jalan Damansara, 46350 Petaling Jaya, Selangor, Malaysia. Tel : +603 - 7731 9333 Email: sales@pay-link.net Website: www.pay-link.net
Should be Empty:

Paylink Payment Gateway Application Form

Merchant Registration Information

Applicant / Contact Person

Merchant Bank Information (Settlement Account)

Declaration

Service Application Checklist

Introducer (if any)