Control Number

Merchant Application & Agreement (Philippines)

Type of Application
New Merchant (NTG) Additional Outlet (eNTG) REF MID: Additional Facility REF MID:

POS # POS Online Website:

Mobile
PAX
Desktop
Dial-up Telco Provider

Business Information
Merchant Trade Name (DBA): Merchant's Legal / Registered Name:

Outlet Address : Legal / Registered Address:

ZIP CODE: ZIP CODE:

DBA Phone: Fax: Corp. Phone/ Cell #: Fax:

Contact Name at this Address: E-mail: Contact Name at this Address: E-mail:

Customer Service Phone # (Required for MOTO and Internet merchants only): Website Address (Required for Internet merchants):

Merchant Profile Credit Card Information

Type of Ownership: Sole Proprietor Partnership Market Type: Travel Agent Sales Profile (Must equal 100%)
Corporation Others: Retail Supermarket
Card Swiped %
Type or Goods or Services Sold: MCC Restaurant Emerging Mkt

Lodging Public Sector

Manual Process %
Years in business under current ownership? Business Registration No. (TIN#) MO/TO Auto Rental

P - Card Cash Adv. Mail Order/Telephone %

E-Comm. Others Internet %
Taxable Status: Taxable Non-Taxable Total = 100 %
Do you currently accept Visa/MasterCard? YES NO
Does merchant accept transactions before the customer receives product or service? YES NO % of sales in this category? %
How long does customer wait before product is received? % of deposit prepaid by customer %
Does merchant offer warranties, dues, subscriptions, memberships or other extended services? YES NO Duration of extended service or benefit (in weeks):
Annual Credit Card Sales: Average Ticket: Total Credit Card Sales (multiple locations only):
Owner/Officer Information (NTG)
Name: Title: Passport No. / Primary ID No. Home Phone #

Home Address:
Unit Floor Number Building Street Subd/Barangay City Country Years There Own / Rent?
Philippines
Former Address (if less than 1 year at current address):
Unit Floor Number Building Street Subd/Barangay City Country Years There Own / Rent?
Philippines
Name: Title: Passport No. Home Phone #

Home Address:
Unit Floor Number Building Street Subd/Barangay City Country Years There Own / Rent?
Philippines
Former Address (if less than 1 year at current address):
Unit Floor Number Building Street Subd/Barangay City Country Years There Own / Rent?
Philippines
Bank Information for Payment/Settlement
Credit to Account-CTA (Applicable for HSBC Philippines accounts only) Cashier Order (for PHP Payments) (Existing Merchant)
Account Number (PHP) Demand Draft (for USD Payments) - Only for merchants paid in USD
- - Check (Existing Merchant)
Deliver CO/DD to Merchant
Delivery Address:
Credit to Account- CTA (Applicable for BPI bank accounts)

Account Number (PHP)

PESONET (Applicable to local banks accounts only)

Bank Name GP Internal Use
Branch Name Opening Date:
Bank Account Number Chain:
SWIFT CODE/BIC Crep: Relationship Manager
Branch Code: Sales Rep Code
Marketing Rep. Code:
 NTG eNTG (or Additional Facility)
Unique Chain Hierarchy # (add to Chain)
Parent Crep #

Merchant Application & Agreement (Philippines)

Credit /Debit Card Service and Fee Schedule (Subject to the Card Services Terms and Conditions)

CARD TYPE Discount Rate CARD TYPE Discount Rate

Petron Card % Master Card Rate %
Ayala Card % Visa Rate %
American Express (Amex) % Philippine Local Debit (Bancnet) %
Email Add: Contact#
WeChat %
Alipay %
China Union Pay (CUP) % Others %
Japan Credit Bureau (JCB) % Transaction Fixed Fee Php
Visa Cross Border (LCY) % P. Table
Visa Cross Border (SCT) % IC++ Table
Master Card Cross Border (LCY) %
Master Card Cross border (SCT) %
* Cross Border Fees applied on top of the quoted Discount Rates

FEE TYPE
Other Fees _____________ Monthly Php Annual Php Per Item Php________
Auto -Debit from Settlement
Cheque Payment

POS Rental QTY:____ Monthly Php Annual Php Per Item Php________
Auto -Debit from Settlement
Cheque Payment
Deposit / Fund Transfer to Global Payments' BPI Account
Refund Processing Fee
F D (charge MDR for refund transaction) F N (Return MDR for refund transaction)

Installment Plan Information (Subject to Card Services Terms and Conditions)

(for Tangent Merchant)
BPI
Assessment Fee/MDR
POS Reference MID (For eNTG) Online SIP

BPI Regular Installment BPI Regular Installment 3 6 9 12 `18 24 `36

BPI Real 0% Installment (w/ Conforme for NTG) BPI Real 0% Installment(w/ Conforme for NTG) 3 6 9 12 18 24 36
BPI Madness (w/ Conforme for NTG) BPI Madness (w/ Conforme for NTG) 3 6 9 12 18 24 36

HSBC Payment Terms

(sales provide rates) 3M 6M 9M 12M 18M 24M 36M (Internal Use)
(for Tangent Merchant)
Discount Rates
% % % % % % % Assessment Fee/MDR
Min. Transact Amount 3K 3K 4,500 6,000 9,000 12,000 18,000

CITIBANK Payment Terms

(sales provide rates) 3M 6M 9M 12M 18M 24M 36M

Discount Rates
% % % % % % %
Min. Transact Amount Php 3000

East West Bank Payment Terms

(sales provide rates) 3M 6M 9M 12M 18M 24M 36M

Discount Rates
% % % % % % NA
Min. Transact Amount Php 3000

Bank of Commerce Payment Terms

(sales provide rates) 3M 6M 9M 12M 18M 24M 36M

Discount Rates
% % % % % % NA
Min. Transact Amount Php 3000

Conforme

Merchant's Legal / Registered Name :

DBA name:

Signing for and on behalf of Merchant: (more than one signatories are required for partnership and corporation etc.)

Signature : ___________________________________________________ /_______________________________________________________

Name(s): ___________________________________________________ /_______________________________________________________

Title(s) : ___________________________________________________ /_______________________________________________________

Date: ___________________________________________________
 Control Number

Merchant Application & Agreement (Philippines)

Transaction Types and Currencies:
Transaction Type:

Retail Sales Mail Order Sales Telephone Order Sales Internet-based Sales Instalment Plan Others:

Accepted Currencies for Card Transactions:

Php USD E-Commerce Indicator :

Agreement Particulars
Timeframe for Payment:

Within two (2) business days after submission of Card Transaction in accordance with the Card Services Terms and Conditions

Term of Agreement:
This Agreement shall take effect upon this Merchant Application being signed by Merchant and Global Payments as provided below and shall remain in full force and effect for an initial term of one year and shall be
automatically extended for successive one-year period --thereafter, unless earlier terminated according to the terms of this Agreement.

Customer Service
All questions regarding Card Services should be referred to Global Payments Asia-Pacific Philippines Incorporated- Hotlines 1800 1441 0374 (PLDT) or 581 6363 (Globe and others)

Note: Billing disputes must be forwarded, in writing, to Merchant Service within 30 days of the date of the statement and/or notice.
Global Payments Contact:
Global Payments Asia-Pacific Philippines Incorporated
16th Floor, Vertis North Corporate Center 3,
#50 North Ave. cor. Mindanao Avenue. Brgy. Bagong Pag Asa,
QUEZON CITY 1105, PHILIPPINE

Acceptance of Terms & Conditions / Merchant Authorization

Your Merchant Card Services Agreement, comprising of this Merchant Application & Agreement and the Merchant Card Services Terms and Conditions attached, is made between Global Payments Asia-Pacific Philippines Incorporated ("Global Payments")
and the Merchant named above

Please sign below to signify that you have received a copy of the Merchant Card Services Terms & Conditions and the Merchant Card Services Acceptance Guide and that you agree to all terms and conditions contained therein and herein. If this
Merchant Application & Agreement is accepted by Global Payments for card services, Merchant agrees that it will be bound by the terms of this Agreement, as may be modified or amended in the future in accordance with its terms. If you disagree with any
terms of this Agreement, do not submit this Merchant Application & Agreement and/or any Card Transaction to Global Payments hereunder.

IF MERCHANT SUBMITS A TRANSACTION TO GLOBAL PAYMENTS HEREUNDER, MERCHANT WILL BE DEEMED TO HAVE ACCEPTED THE TERMS & CONDITIONS OF THIS AGREEMENT.

By the signature below, Merchant:

(a) certifies that all information provided in this Merchant Application & Agreement is true and accurate;

(b) authorizes Global Payments to: (i) initiate debit entries to any of the Merchant's Account(s) in accordance with the Merchant Card Services Terms and Conditions and (ii) initiate debit entries to any of the Merchant's Account(s) for the application fees
described herein prior to Global Payments's acceptance and execution of this Merchant Application & Agreement, which application fees shall be retained by Global Payments whether or not the Merchant Application & Agreement is accepted and executed
by Global Payments;

(c) authorizes the financial institution(s) with which any of the Merchant’s Account(s) are maintained to honour such debit entries initiated by Global Payments; and
(d) irrevocably authorises Global Payments to include the Merchant's name, address, contact person name, telephone and facsimile numbers in any directory (including without limitation any online directory on an Internet website accessible by public) or
promotional material produced in connection with the acceptance of Cards.
(e) authorizes Global Payments to release any information in its possession relating to Merchant and its principals to Global Payments as part of credit assessment process; and
(f) authorizes Global Payments to access credit report (s) of Merchant and its principals as part of credit assessment process.

Signing for and on behalf of Merchant and Global Payments

Merchant's Legal / Registered Name :

Signing for and on behalf of Merchant: (more than one signatories are required for partnership and corporation etc.)

Signature :

Name(s):

Title(s) :

Date:
(MMM, DD, YYYY)

Signing for and on behalf of Global Payments Asia-Pacific Philippines Incorporated:

Name:
Print Name and Signature
Title :

Date :
(MMM DD, YYYY)

We/I hereby certify to the best of our/my current knowledge as of the date that this agreement was signed, there is no known owner, officer, director, or agent which is a current or
former official in the executive, legislative, administrative, military, or judicial branch of any government (elected or not); an official of a political party; an executive of a government-
owned commercial enterprise; a family member of any of the above mentioned officials; or a close personal or professional associate of any of the above mentioned officials.
Signing for and on behalf of Merchant:

Signature : _____________________________________
Title : ________________________________________

If you are affiliated with any such person, please identify the owner, officer, director, or agent.
_____________________________________________________________________________
_____________________________________________________________________________
 Control Number

Merchant Application & Agreement (Philippines)

Certificate of Due Authorization (for corporations only)
I hereby certify that resolutions were passed at a meeting of the Board of Directors of Merchant on that
1. The terms of this Agreement be approved; (MMM DD, YYYY)
2. The director(s) whose name and signature appear above be authorized to sign this Merchant Application on behalf of Merchant;
3. Any one or more directors be authorized to take all other actions and sign all other documents in connection with this Merchant Application; and
4. Details of these resolutions be communicated to Global Payments and remain in force until an amending resolution shall have been passed by Merchant’s Board
of Directors and a Certified copy thereof shall have been received by Global Payments.

I further certify that Merchant has the power to enter into and perform this Agreement and that details of the above resolutions have been entered into the Minute Book of Merchant and
signed therein by the Chairman of the meeting and are in accordance with Merchant’s Memorandum and Articles of Association or equivalent constitutional documents.

Signature (Chairman of the meeting)

Name:

Date:
(MMM DD, YYYY)

Personal Guarantee (if applicable-Individual)

I/We hereby guarantee to Global Payments and its successors and assigns, the full, prompt, and complete performance of Merchant and all of Merchant's obligations under the Merchant
Card Services Agreement, including but not limited to all monetary obligations arising out of Merchant's performance or non-performance under the Merchant Card Services Agreement,
whether arising before or after termination of the Merchant Card Services Agreement. This guarantee shall not be discharged or otherwise affected by any waiver, indulgence,
compromise, settlement, extension of credit, or variation of terms of the Merchant Card Services Agreement made by or agreed to by Global Payments and/or Merchant. I/We hereby
waive any notice of acceptance of this guaranty, notice of nonpayment or nonperformance of any provision of the Merchant Card Services Agreement by Merchant, and all other notices

or demands regarding the Merchant Card Services Agreement. I/We agree to promptly provide to Global Payments any information requested by it from time to time concerning my/our
financial condition(s), business history, business relationships, and employment information. I/We have read, understand, and agree to be bound by the Merchant Card Services Terms
& Conditions provided to Merchant and those terms and conditions contained in this Merchant Application & Agreement.

Signature of Guarantor (please sign below) Name (printed):

Signature of Witness (please sign below) Name (printed):