First Name

Last Name

Position

Email address

General Information

Legal Company Name

Website address

Industry

Certificate Type

Main contact person for the onboarding process

Email address

Phone Number

Online Communication Tools

Certificate of Production

Can you provide rental agreements for your premises?

Yes

No

Can you provide 3rd party lab test results for products?

Yes

No

Does your product contains one of the following ingredients? (multiple selection):

Processing Breakdown

Please indicate the estimated percentage of total processing volume for each region to be processed through the Zota gateway technology.

Major regions of traffic source (split by % of traffic): Remaining: 100%

Europe:

LATAM:

China:

USA:

Southeast Asia:

MENA:

Africa:

CIS:

East Asia:

Oceania:

South Asia:

Other:

Global:

Major countries in selected regions:

Estimated monthly volume for target regions (total USD):

Average Transaction size (USD):

Base currency (which your reports will be based on):

Settlement currencies required (multiple selection):

EUR USD JPY USDT

Financial contact email for reporting:

Company Details

Country of incorporation

Date of incorporation

Registration Number

Registered Office Address

Add owner/s with more than 10% share

Remove this owner

Type of Ownership

Individual Owner Details
(Shareholders with more than 10%) Holding Company

First Name

Last Name

Ownership %

Nationality

ID/Passport No.

Place of issue

Date of Birth

Email address

Phone Number

Registered Address

Company Name

Ownership %

Country of incorporation

Date of Incorporation

Registration Number

Registered Office Address

Add Holding Company or Individual Owner (shareholder with more than 10%)

Company Director/s

Remove this Director

First Name

Last Name

Nationality

ID/Passport No.

Place of issue

Date of Birth

Email address

Phone Number

Registered Address

Authorized Signatory

Yes

No

Add Director

Technical Information

Technical Contact Email Address for Integration Purposes

Are you using a specific platform/shopping cart/ecommerce plugin?

Yes

No

Name of the specific platform for integration

Are you currently processing with another payment processor?

Yes

No

Name of current/former processor:

Do you have corporate banking in the name of your legal entity?

Yes

No

Banking Information

Bank Name:

Bank Address:

State/Country:

City/Town:

ZIP/Post code:

Bank Sort code:

SWIFT/BIC code:

Contact person at bank:

Phone for contact person at bank:

Account holder:

Account holder country:

Account number:

IBAN:

Currency:

CBD

General Information

Processing Breakdown

Company Details

Add owner/s with more than 10% share

Company Director/s

Technical Information

Banking Information

Thank You!