Merchant Registration
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BUSINESS DETAILS
Merchant Name
Trade Name
Contact Number
Merchant Complete Address
Years in Business
No. of Outlets
Sector
Nature of Business
Type of Products
Business Days & Hours
Tax Identification No.
Permit No.
Date Issued
Registered Owner
Designation
Authorized Signatory
Designation
Contact No.
Email Address
Residential Address
BANK ACCOUNT
Bank Name
Account Number
Branch
I hereby confirm that the above confirmation is true and correct,
and I hereby authorize Palenke.ph Inc. to process my Merchant Account.
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