Professional offshore incorporations and offshore banking services since 1996

OffshoreSimple.com

    Merchant Application

    Please complete for the form below and a member of our business development team will contact you shortly:
     

    We mainly focus on dealing with new or existing online gaming, adult website and online pharmacy merchants. Also, it is hardly for us to deal with the clients whose monthly turnover is under $20,000
    (even if it is estimated volume).

    Items marked with * are required.

    Company Name *

     

    Contact Name *

     

    Email *

     

    Telephone *

     

    Address

     

    Post Code / ZIP                                                               

    Country *

     

    Nature of your business * Max 50 Words

     
    URL
    Business Type

      European Incorporation 

    Country of Incorporation *
    Current Processor
       
      Banking Details
       
    Bank Name
    Address
    Post Code / ZIP
    Country
    Account Name
    Account # / IBAN
    ABA / Swift / Sort Code / Routing #  

         VAT No 

       
      Projected Volume Details
       
      Type in your projected processing volumes (enter 6 Months)

    Month 1  *

    USD

    Month 2 USD

    Month 3

    USD

    Month 4 USD

    Month 5

    USD

    Month 6 USD

    Enter Average Ticket Size USD
       
      Technical Contact Information
       

    Technical Contact Name

    Email

    Telephone

       

    Where did you hear about us?