m8 ING ois - MERCHANT REGISTRATION FORM MERCHANT I ACQUIRER: (FOR INTERNAL USE ONLY) Merchant Name Food Trucks Hawkers Pasar Matam GPasar Pag 1G Food court wee Market ‘Transportation Flea Market Others; nooo ‘Merchant Category Total Number of shops) Reload PIN Prefix No (if Applicable) ‘Bank Account Holder Name Bank Name Bank Account No i Company Name ‘Company Registration Number Business Lense Expiry Date Owner's Name (Owners IC No ‘Motte Phone (or transaction notification) Email (for dally settlement report) Contact Person mR Rs: ‘oTHeRs: looo Contact Person Title Current Business Address (Address may vary from address registered with ssm/80l) hereby declare and undertake cry NAIC No: that all information provided herein is true and accurate and | further consent to the use and disclosure of my personal Information in accordance with TNG Digital Sdn Bha's privacy policy. further declare and undertake that the Merchant herein registered ts not involved or implicated in any criminal or illegal activities. | hereby acknowledge that | have read, ‘understood and agreed to the terms and conditions of the Merchant Agreement (Appendix 1) a8 attached herewith. ‘Merchant's Signature Date ‘ING Digital Sdn Ghd reserves the right to verify any Information provided by you and reserves the right to decline amy application without any reason thereof and snot obligated to respond to any request on any unsuccessful application ‘ING Digital Sn Bh iat Level 3A, Tower 6, Avenue 5, Bangsar South No.8 Jalon Kerinchi, $7200, Kuala Lumpur, Maleysia a