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Name and Surname*
E-mail*
Phone
City (select the city closest to you from the list)
Message*
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APPLICATION FORM
* — Mandatory fields
Merchanat legal information
Name*
Taxpayer Identification Number (TIN)*
City
МОСКВА
Postal code*
Address*
Actual information about the merchant
Country
РОССИЯ
City
МОСКВА
Postal code*
Address*
Date of registration (DD.MM.YYYY)
Number of employees
General director
Surname*
Name*
WEB-site address*
Number of web-sites*
Description of services offered on the site*
Monthly turnover on payment cards, RUR*
Average ticket, RUR*
Estimated monthly number of transactions*
Country of card usage*
Russia
Recurring transactions
No
Contact person of the merchant
Surname*
Name*
Position*
Phone*
E-mail *
City of UCS branch*
МОСКВА
Enter code*
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APPLICATION FORM
* — Mandatory fields
Merchanat legal information
Name*
Taxpayer Identification Number (TIN)*
City
МОСКВА