MOST IMPORTANT DOCUMENT (Ver 1.

1)

Declaration
To,
The Manager,
HDFC Bank Merchant Services, Mumbai

Branch code
LG Code
LC Code

Dear Sir,
ME App No.
Subject: Application for HDFC Bank POS Solutions
This is to confirm that I am/ we are submitting application for HDFC Bank Four-in-1 POS solution along with all required
documents, as per the options ticked below:

Four-in-1 Options/ Commercials

POS(Landline) Terminal

Monthly Rental Nil*

*In case the monthly volume per TID per month is Rs.15000/- and above

PayZapp for Business

Monthly Rental Nil, Setup fees - Nil (Standard Rate - Rs.3000)

MPOS Terminal (NonIntegrated) Per Tid Per Month

GPRS Terminal Per Tid Per
Month

Monthly Rental Rs_______________ (Standard Rate - Rs.300/-)

Monthly Rental Rs. ______________ (Standard Rate @ Rs.1000)

Value Added Services

Flexi-currency (DCC)

Special offer 100% Ploughback of the MDR

AnyCard EMI
Terms & Conditions:

st

The Four-in-1 special options/commercials are valid till 31 March, 2016. All applicable taxes & government levies extra.
The Merchant Discount Rate will be the same for all POS (Landline), PayZapp for Business solution, MPOS terminal & GPRS
terminal you have availed from us for your Establishment.
We hereby acknowledge and accept that terms and conditions contained in the Merchant Acquiring agreement entered between us
and HDFC Bank will remain binding and extended to all of the above.

Name of the Authorized Signatory and Merchant Establishment

Contact details of Authorised Signatory:

Mobile No:

Signature

Alternate Mobile No
Email ID

Stamp/Seal

-------------------------------For Office Use-------------------------------------Existing Merchant

Yes

No

In case of an existing merchant, kindly furnish the below details:

ME Code
Terminal ID No.

Current Acquiring details:

Sr
No

Bank name

HDFC Bank

2
3
4

Expected volume pm

EMI/CD volume pm

FX/DCC volume pm

MDR