Merchant Billing Registration

Business name *

Trading as name

Country of business registration *

Company registration number

What industry is your business in?

VAT number

Business Address

Street

City

Postal code

State/Province

Country

Same as billing address

Yes

Website

Main Contact

Contact full name & surname

Email Address

Phone/Mobile

Communication Preferences

Accounts/Billing

Sales

Technical

Marketing

Project

Billing Contact

Contact full name & surname

Phone/Mobile *

Communication Preferences

Accounts/Billing

Sales

Technical

Marketing

Project

Service Selection

Shopify: An e-commerce platform for online stores and retail point-of-sale systems, offering a suite of services including payments, marketing, shipping and customer engagement tools. Link: https://www.iveri.co.za/shopify | Fees: 1% of transaction value

Where did you hear about us?

Have you already liased with anyone from iVeri

Yes

I have read, understood and agree to the Software License Terms.

I have read and understood the Service Terms.

I acknowledge that the details and information provided are true and correct to the best of my
knowledge, and that I am authorised to submit this request on behalf of the company.

Subject *

Submit

Merchant Billing Registration

Business Address

Main Contact

Billing Contact

Thank you for your registration