Integrated Payment Solution Application Form

You apply; we’ll handle the transactions.

Requirements

Once you’ve completed the application, we'll qualify your company based on the size of your consumer-base and other factors. We’ll then send you the necessary legal and supporting documents you need to sign, so that we can get the ball rolling.

01 Business Details

02 Address details

03 Contact person

04 Current payment details

01/04

Business Details

Registered business name

Company registration number

Vat number

Website URL

Briefly explain what your company does.

Continue

02/04

Address details

Business Address

Suburb

City or town

Postal Code

Province

Please select

Eastern Cape
Free State
Gauteng
KwaZulu-Natal
Limpopo
Mpumalanga
Northern Cape
North West
Western Cape

Country

Please select

South Africa
Other

Suburb

City or town

Postal Code

Province

Please select

Eastern Cape
Free State
Gauteng
KwaZulu-Natal
Limpopo
Mpumalanga
Northern Cape
North West
Western Cape

Country

Please select

South Africa
Other

Continue

03/04

Contact person.

First Name

Surname

Contact number

Business Email address

Continue

04/04

Current payment details.

Current customer base

Please select an option

0-1000
1 000 - 5 000
5 000 - 10 000
10 000 - 50 000
50 000+

Biller category

Please Choose

Betting & Gaming
Debit Collection
Deposit/ Top-up
Insurance
Loan Repayment
Money Transfer
Other Commercial Bills
Remttance
Travel Ticketing

Current payment methods available to customers

EFT
Debit Order
Direct Deposits at Bank
Other Payment Methods

Customer payment frequency

Please choose

Monthly Payment
Ad Hoc Payments

Monthly Average Transaction Value

I accept that my information may be used by Pay@ for any news and important updates

Please agree to the terms above.

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You apply; we’ll handle the transactions.

Requirements

01/04

Business Details

02/04

Address details

03/04

Contact person.

04/04

Current payment details.

Thanks for taking the first step towards easing your payment frustrations.

We will be in touch once we’ve had a look at your company and how we can best assist you. We can’t wait to take things to the next level.

Make a Payment.

Sign Up

You apply; we’ll handle the transactions.

Requirements

01/04

Business Details

02/04

Address details

03/04

Contact person.

04/04

Current payment details.

Thanks for taking the first step towards easing your payment frustrations.

We will be in touch once we’ve had a look at your company and how we can best assist you. We can’t wait to take things to the next level.