Touch N Go Merchant Application Form

Merchant Name (Business Name)*
As per IC for without SSM /BOL registration
Total Number of Shop(s)*
Merchant Category*

Sdn. BhdEnterpriseSole Proprietor (with business operation license "BOL")Individual Trader (Without BOL)PartnershipOther
Nature of Business*
Shop / Stall / booth photo / Products*

Upload Your Photo here
product photo for Facebook Page user ONLY Cancelof
Company Name
As per SSM
Company Registration Number
As per SSM
Business License Expiry Date
as per SSM
SSM full set

Upload SSM here
For registration with SSM / BOL Cancelof
Bank Account Number*
Bank Name
MBB, PBB, CIMB, HLB, ..ect
Bank Account Holder Name*
As per IC for without SSM /BOL registration
Bank Statement

Header Upload
c/w your Bank number Cancelof
Owner's Name*
AS PER IC
Owner's IC No*
Merchant's IC Front & Back*

IC front & back
kad pengenalan depan & belakang Cancelof
Mobile Phone *
1) 2) 3) Merchant App eWallet number
Mobil Phone*
for transaction notification
Contact Person*
Email*
example@example.com
Current Business Address*
( Address may vary from address registered with SSM / BOL). For Individual Trader Without BOL use ic address
Touch n Go eWallet Photo*

As sample given screen shoot & UPLOAD HERE
Verified Completed User ( for Individual Trader Without SSM/ BOL ) Cancelof
Hereby i declare and undertake that all information provided herein is true and accurate and i furture consent to the use and disclosure of my personal information in accordance with TNG Digital Sdn. Bhd's privacy policy, I furture declare and undertake that the Merchant herein resgistered is not involved or implicated in any criminal or illegal activities. i hereby acknowledge that i have read, understood and agreed to the terms and conditions of the Merchant Agreement (Appendix 1 ) and Merchant/ Individual trader do and don't guideline as attached herewith
Terms & Conditions as above*

YES I agreed
Merchant's Signature(& company Stamp)*
Date
Should be Empty: