Merchant Application Form

For new terminal applications please fill in our Merchant Application Form below.

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How long has the Principal/Business been known to MCB?

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

Date business open

KvK/Chamber of Commerce #

KvK/Chamber of Commerce Extract

Only PDF and Image formats are allowed

Visible name Display at location

Business hours

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

Principal's name (owner/director)

Principals telephone number

Principals address

Place of Birth

Identification number

Please upload a copy of your ID

Only PDF and Image formats are allowed