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1
What is your full name?
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First Name
Last Name
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2
What is your email address?
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example@example.com
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3
What is your phone number?
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4
What is your company's name?
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Please provide the full company name!
e.g. My Company Limited
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5
What is your title?
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e.g. CEO, VP Sale, etc.
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6
What is your company's website address?
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7
In which country do you live?
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8
In which country is your company incorporated?
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9
What is your company's size?
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Please choose the answer that best describes your business!
Sole Trader
2-50 Employees
50-100 Employees
More than 100 Employees
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10
What industry are you in?
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Please choose the answer that best describes your business!
Please Select
Accounting Services Provider
Amusement/Recreation Services Provider
Car Wash
Children's Classes Provider
Clothing and/or Fashion Accessories Store
Consumer Electronics Seller
Contractors/Construction Company
Cosmetic/Beauty Product Seller
Driving Instructor
Food Stall/Truck Vendor
Furniture/Home Furnishing Seller
Hairdresser and/or Beauty Salon
Heating/Plumbing/AirCon Contractor
Hobby, Toy, and Game Shops
Legal Services Provider
Logistics & Delivery Services
Mobile Phone Repair Services Provider
Personal Assistant/Concierge Services
Pet-Related Products Seller
Photographer and/or Photographic Studio
Restaurant
Sporting Goods Store
Supermarket/Grocery Store
Taxi/Limousine Operator
Utilities/Telecommunications Services Provider
Vehicle Repair Services Provider
Web Designer
Accommodation Services Provider
Adoption Agency
Advertising Services Provider
Adult Physical Goods Seller
Alcohol Seller
Animal/Animal Parts Seller
Art Dealer
Auction House
Audio Licensing/Sound Bite Provider
Cannabis-Related Products Seller
Caterer
Charitable Organizations
Company Formation Services
Computer Software Seller
Consultancy Services Provider
COVID-19 Test Laboratory
Dating Services Provider
Debt Collection/Management Services Provider
Discount/Promotion Code Reseller
E-Book Subscription Seller
Event Organiser
Financial Skill Games Platform
Fireworks Seller
Gambling Operator
Immigration Services Provider
Insurance Services Provider
Lottery Messenger
Lottery Syndicate
Medical Services Provider
Money Remittance Services Provider
NFT Seller
Nootropics Seller
Online Gaming Platform Operator
Online News Outlet
Online Personal-Development Courses Provider
Online Professional Courses Provider
Pharmaceuticals Seller
Prize Competitions Operator
Professional Cleaning Services Provider
Proprietary Trading (PropTrading) Platform Operator
Securities Trading Operator
Skill Games Operator
Smoking/Vaping Products Seller
Stock Image Seller
Ticket Broker
Travel Agency
Vehicle Data Checking Service Provider
Vehicle Dealer/Seller
Vehicle Rental and/or Leasing Agent
Virtual Currency Exchange
Voucher/Gift Card Broker
Weapons Seller
Adult Content Services Provider
Airline
Appliance Cover Provider
Coin/Precious Metal Dealer
Cruise Line Operator
Cyber-Locker Services Provider
E-Commerce Marketplace
E-Wallet Operator
Escort Services Provider
In-Game/Virtual Goods Platform Operator
Mysticism /Divination Services Provider
NFT Marketplace
Nutraceutical Products Seller
Online Fan Engagement Platform Provider
Online Gambling Courses Provider
Online Trading Courses Provider
Payday Loans Provider
Psychedelics Seller
Real-Estate Broker
Sex-Dating Services Provider
Technical Support Services Provider
Tour Operator
Web Hosting Service Providers
Website Traffic Generator
Please Select
Please Select
Accounting Services Provider
Amusement/Recreation Services Provider
Car Wash
Children's Classes Provider
Clothing and/or Fashion Accessories Store
Consumer Electronics Seller
Contractors/Construction Company
Cosmetic/Beauty Product Seller
Driving Instructor
Food Stall/Truck Vendor
Furniture/Home Furnishing Seller
Hairdresser and/or Beauty Salon
Heating/Plumbing/AirCon Contractor
Hobby, Toy, and Game Shops
Legal Services Provider
Logistics & Delivery Services
Mobile Phone Repair Services Provider
Personal Assistant/Concierge Services
Pet-Related Products Seller
Photographer and/or Photographic Studio
Restaurant
Sporting Goods Store
Supermarket/Grocery Store
Taxi/Limousine Operator
Utilities/Telecommunications Services Provider
Vehicle Repair Services Provider
Web Designer
Accommodation Services Provider
Adoption Agency
Advertising Services Provider
Adult Physical Goods Seller
Alcohol Seller
Animal/Animal Parts Seller
Art Dealer
Auction House
Audio Licensing/Sound Bite Provider
Cannabis-Related Products Seller
Caterer
Charitable Organizations
Company Formation Services
Computer Software Seller
Consultancy Services Provider
COVID-19 Test Laboratory
Dating Services Provider
Debt Collection/Management Services Provider
Discount/Promotion Code Reseller
E-Book Subscription Seller
Event Organiser
Financial Skill Games Platform
Fireworks Seller
Gambling Operator
Immigration Services Provider
Insurance Services Provider
Lottery Messenger
Lottery Syndicate
Medical Services Provider
Money Remittance Services Provider
NFT Seller
Nootropics Seller
Online Gaming Platform Operator
Online News Outlet
Online Personal-Development Courses Provider
Online Professional Courses Provider
Pharmaceuticals Seller
Prize Competitions Operator
Professional Cleaning Services Provider
Proprietary Trading (PropTrading) Platform Operator
Securities Trading Operator
Skill Games Operator
Smoking/Vaping Products Seller
Stock Image Seller
Ticket Broker
Travel Agency
Vehicle Data Checking Service Provider
Vehicle Dealer/Seller
Vehicle Rental and/or Leasing Agent
Virtual Currency Exchange
Voucher/Gift Card Broker
Weapons Seller
Adult Content Services Provider
Airline
Appliance Cover Provider
Coin/Precious Metal Dealer
Cruise Line Operator
Cyber-Locker Services Provider
E-Commerce Marketplace
E-Wallet Operator
Escort Services Provider
In-Game/Virtual Goods Platform Operator
Mysticism /Divination Services Provider
NFT Marketplace
Nutraceutical Products Seller
Online Fan Engagement Platform Provider
Online Gambling Courses Provider
Online Trading Courses Provider
Payday Loans Provider
Psychedelics Seller
Real-Estate Broker
Sex-Dating Services Provider
Technical Support Services Provider
Tour Operator
Web Hosting Service Providers
Website Traffic Generator
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11
Are you currently processing payments?
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i.e. accepting credit/debit cards in your business
Currently not processing
Yes, but less than 3 months
Yes, for more than 3 months
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12
Who is your current provider?
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13
Why do you want to replace your current provider?
*
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Please choose all reasons that apply!
Current provider’s service is unsatisfactory
Current account was terminated
Current provider is too expensive
Looking to add an additional provider
Other
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14
Why do you want to change your current provider?
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15
Is your business an e-commerce business?
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i.e. do you sell online?
Yes
No
Not yet, but there’s an intention to
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16
To which platform is your website connected to/built with?
*
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Please Select
Leverate
WooCommerce
Magento
PayNetEasy
CommDoo
Coriunder
Worldline-Bambora (DevCode)
Praxis
BridgerPay
BitcoBrokers
Wix
PrestaShop
sticky.io
Konnektive
Checkout Champ
osCommerce
SoftGamings
Shopify
ShopWired
Other
Please Select
Please Select
Leverate
WooCommerce
Magento
PayNetEasy
CommDoo
Coriunder
Worldline-Bambora (DevCode)
Praxis
BridgerPay
BitcoBrokers
Wix
PrestaShop
sticky.io
Konnektive
Checkout Champ
osCommerce
SoftGamings
Shopify
ShopWired
Other
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17
How would you describe your average risk performance?
*
This field is required.
Chargeback ratio is between 1%-5%, but Fraud ratio is below 1%
Fraud and Chargeback ratios are below 1%
Fraud ratio is between 1%-5%, but Chargeback ratio is below 1%
Fraud and/or Chargeback ratio is above 5%
No information available
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18
To which platform is your website connected to/built with?
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19
What is your current processing volume?
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monthly processing volume, NOT annual!
Currently not processing
Less than £10,000
£10,000-£50,000
£50,000-£100,000
£100,000-£500,000
£500,000-£1,000,000
More than £1,000,000
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20
What solution(s) are you looking for?
Huge
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Normal
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quote
Created with Sketch.
Ok
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21
By submitting this form, you agree to our Privacy Policy and allow Fibonatix to contact you about your inquiry and relevant services. View our full Privacy Policy at www.fibonatix.com/privacy-policy
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22
Form Channel
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23
Form Source
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24
PSS 1 - Name
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25
PSS 2 - Name
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26
Get Page URL
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27
Analytics Widget
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