Aount Contrat for Card Aeptane This is an Aount Contrat for the aeptane of debit ards and redit ards via payment terminals, on the website and/or by telephone, mail or fax. You enter into this ontrat with Paysquare SE and Stihting Third Party Fund Paysquare Foundation. This foundation will hold the funds intended for you separately before paying them to you. In this ontrat you will be asked to provide a substantial amount of information, inluding details about your ompany and your business operations. This information is required in order to omply with the striter laws and regulations and with the requirements imposed on us by the ard shemes. In addition, we feel it is important to be able to provide you with personal information and advie, as this allows you to benefit from the highest-quality servies as well as remain up-to-date on payment trends. In order for us to reate an aount for you, you must omplete all setions of this Aount Contrat, and the requested attahments must be learly legible and inlude lear, high-quality pitures. You will be able to use the required payment methods to aept payments quikly and easily. The ontrat is divided into 4 setions: 1 Information about your ompany 2 Payment terminal aeptane 3 Aeptane on the website 4 Terms and onditions and signatures Please note: You must in any event omplete setions 1 and 4, and, depending on your requirements, you an additionally omplete setion 2 and/or 3. PaySquare SE Eendrahtlaan 315, 3526 LB Utreht, the Netherlands Postbus 30600, NL-3503 AJ Utreht, the Netherlands T +31 (0)30 283 73 33 E onnet@paysquare.nl www.paysquare.nl Setion 1 Information about your ompany Paragraph 1.1 Your ompany Trade name Legal / Corporate name (as registered with the Chamber of Commere) Chamber of Commere number Business address Street name + number (no PO boxes) Postode and town/ity Telephone number Website Contat person: Mr Ms Initials + surname E-mail address Hereinafter referred to as your Company* * In the General Terms and Conditions of Card Aeptane an be spoken of the Merhant instead of your Company. With this the same is meant. Do you want to register several loations under the same CoC/KBO number? Enlose the Exel overview Extra loations, with the requested information for eah loation. Yes, I would like to register several loations. Please see the Exel overview Extra loations enlosed. Correspondene address PO Box or street name + number Postode and town/ity Telephone number Contat person: Mr Ms Initials + surname E-mail address Same as business address Same as business address Same as business address To be ompleted by PaySquare MCC CIM anr OP ref Peer 1 2 3 Aansluitnummer POS E-ommere MasterCard / Maestro / Visa / V PAY Disover / Diners Club JCB UnionPay MUPP nummer Commissieprofiel Parent lient/customer nr. Profiel(en) betaalautomaat Gelinkt(e) aansluitnummer(s) Host Opdraht Akkoord
Paragraph 1.2 Your Company s ativities 1 Please desribe the goods and/or servies provided by your Company: 2 Do the goods and/or servies provided by your Company require permits? Yes No 3 Is your Company a member of a trade assoiation*? : Membership number: N/A *PaySquare has agreed speial rates with various trade assoiations. 4 Does your Company aept payments on behalf of another ompany? Yes No 5 What is your primary target group? Consumers Businesses Government Other (please speify) 6 How are the goods and/or servies provided? In a physial store Colletion Delivery Downloads Online 7 What is the average delivery time (between order and delivery)? dagen Paragraph 1.3 Bank details (EUR) 1 Benefiiary ( of aount holder as registered with the bank) Bank IBAN* Company name as shown on ardholder s (i.e. Company s ustomer s) aount statements Payment in other urrenies is possible as well please speify your preferene in setions 2 and 3. 2 Did you list several loations under the same CoC/KBO number under 1.1 with the Exel overview Extra loations? Yes I have registered several loations and would like payment to take plae using their individual bank aount numbers. Yes I have registered several loations and would like payment to take plae using the above-mentioned bank aount number for all of them. Not appliable. * From 1 February 2014 onsumers and businesses aross the EU will start using the IBAN (International Bank Aount Number). Paragraph 1.4 Business operations 1 Does your Company have one or more foreign loations? Yes No If you seleted Yes : whih loations? Country Main loation 2 nd loation 3 rd loation 4 th loation 5 th loation Please inlude an attahment if you have more than 5 foreign loations 2 Do one or more assoiate diretors maintain gainful employment elsewhere (i.e. at another ompany)? Yes No If you seleted Yes, please list the ompany or ompanies. 3 Have any of the assoiate diretors ever been delared bankrupt or been involved in a bankrupty? Yes No 4 Have one or more assoiate diretors previously aepted payment ards in their apaity as diretors? Yes No 5 Has your Company previously aepted payment ards? Yes No If you seleted Yes : Through what party (i.e. aquirer) were they aepted? : Town: Country: Annual turnover Visa: MasterCard: Number of transations per year Number of disputed transations in the past 12 months Number of refunds (following the submission of hargebaks) to ardholders in the past 12 months N/A
Paragraph 1.5 Seurity poliy 1 On what type of premises does your Company ondut its operations? Private residene Business premises/offie/shop Other (please speify): Combined residene/business premises Shared offie spae with ommunal failities 2 Where are the goods and/or servies sold by your Company stored and distributed? At/from the same site where your Company onduts its operations From a different site Please explain 3 Does your Company deliver diretly from third-party stok? Yes, from the stok of: No 4 Is your Company in possession of payment ard details after a payment is ompleted? Yes No Not sure 5 Does your Company use any software appliations or suppliers (e.g. stok management, reservation systems, loyalty programmes, et.) that store, proess or transmit payment ard details? Yes No Not sure Paragraph 1.6 Required form of aeptane Selet the desired form(s) of aeptane and proeed as indiated. If you would like several forms of aeptane, fill out all relevant hapters and/or the addendum. Payment ard aeptane at the POS terminal. Complete Chapter 2 and Chapter 4. Payment ard aeptane via your Company website(s). Complete Chapter 3 and Chapter 4. Payment ard aeptane by post, phone or fax (only available in the Netherlands). Complete Chapter 4 and the Mail Order/Telephone Order Online (MO/TO Online) Card Aeptane addendum. Setion 2 Payment terminal aeptane Complete this setion only for payment terminal aeptane of payment ards. Paragraph 2.1 Payment terminal details Number/Verifiation number(s)* Supplier(s) Type of payment terminal(s) *Tip: your statement an easily be heked if you enlose a transation slip. Paragraph 2.2 Expeted turnover and average transation amount Credit Card Debit Card (Maestro, V PAY) Expeted annual turnover Expeted average transation amount Share of orporate redit ards if the payment ards aepted through PaySquare generate an annual turnover of more than 500,000. %
Paragraph 2.3 Payment ards and fees To be ompleted by PaySquare Fees for redit transations and payment term Required payment ards: MasterCard Visa Disover and Diners Club JCB* UnionPay* Commission per transation Perentage Fixed amount Minimum amount Maximum amount Payment term To be ompleted by PaySquare Fees for debit transations and payment term Required payment ards: Commission per transation Commission per loation Maestro V PAY Perentage Fixed amount Minimum amount Maximum amount Payment term Amount per month Aount registration fee: none Depending on the outome of the bakground hek, PaySquare may request additional finanial seurities, inluding a deposit or rolling reserves. *You an aept JCB only in the Netherlands and Belgium and UnionPay only in the Netherlands. Paragraph 2.4 Currenies It is possible to aept foreign urrenies for MasterCard and Visa transations. Payment in different urrenies is possible as well. Requested urrenies for aeptane: Euro only. Besides euro, you an also use foreign urrenies with dynami urreny onversion to/from euro during the transation. You must omplete the DCC Agreement attahment for this purpose. Paragraph 2.5 Seurity poliy 1 Is/are your Company s payment terminal(s) linked diretly to your Company s POS system for data exhange (integrated or linked POS system)? Please hek with your supplier if neessary. Yes No Not sure 2 If you seleted Yes : what type of payment terminal system does your Company use? Make Supplier Type Version 3 Is/are your Company s payment terminal(s) onneted to your Company s own IT infrastruture (i.e. network)? Yes No Not sure 4 Is/are your Company s payment terminal(s) onneted to third-party networks? Yes No Not sure If you would also like aeptane via the website, proeed to Chapter 3. If not, proeed to Chapter 4. Setion 3 Aeptane on the website Complete this setion only for aeptane of payment ards through the website Paragraph 3.1 Expeted turnover and average transation amount Credit Card Debit Card (Maestro, V PAY) Expeted annual turnover Expeted average transation amount Share of orporate redit ards if the payment ards aepted through PaySquare generate an annual turnover of more than 500,000. %
Paragraph 3.2 Payment ards and fees To be ompleted by PaySquare Fees for redit transations and payment term Required payment ards: MasterCard Visa JCB* Commission per transation Commission Fixed amount Minimum amount Maximum amount Payment term To be ompleted by PaySquare Fees for debit transations and payment term Required payment ards: Maestro V PAY Commission per transation Commission Fixed amount Minimum amount Maximum amount Payment term NB: The option to aept the above-mentioned payment ards also depends on your Payment Servie Provider (PSP). Chek whether your PSP failitates this. Company aount fees: 0 for an annual turnover of more than 10,000 using the payment ards aepted through PaySquare; if annual turnover is lower, the fee is 135. Depending on the outome of the bakground hek, PaySquare may request additional finanial seurities, inluding a deposit or rolling reserves. *You an aept JCB in the Netherlands and Belgium only. Paragraph 3.3 Currenies It is possible to aept foreign urrenies for MasterCard and Visa transations. Payment in different urrenies is possible as well. Requested urrenies for aeptane: Euro only. Besides euro, you an also use foreign urrenies with dynami urreny onversion to/from euro during the transation. Please omplete the attahment EDCC Agreement for this purpose. Note: this is only possible if you use Ogone as a Payment Servie Provider. In addition to euro, foreign urrenies are also possible, based on the pries set by your Company in foreign urrenies. You an hoose between payment in euro and payment in a foreign urreny. Please omplete the Attahment ontaining additions and hanges for this purpose. Paragraph 3.4 Goods and Servies 1 Does your Company intend to sell goods and/or servies in (a) foreign market(s)? Yes No If you seleted Yes : what ountries and/or regions? 2 Does the reipient need to sign for delivery of the goods? Yes No 3 Pleas enter all URLs you urrently use/will be using in the future to provide the servies and/or goods. Please enter the login details if a login is required to aess the produts or servies. URL Login Password Live Test site www. www. www. www. www. To be ompleted by PaySquare Aeptane N.B.: If you will be using more than 5 URLs, please inlude all the additional URLs, inluding the login and password for eah, in a separate attahment. Your Company must be the owner of all URLs provided, and these must be registered under the same name as listed in the Chamber of Commere register. PaySquare periodially heks the URLs operated by your Company where the produts and/or servies are provided. Please note: these heks are possible only for live websites. If you do not inlude all the URLs or do not provide notifiation of URLs added at a later time, this will onstitute grounds for PaySquare to refuse to enter into, or terminate, the ontrat. In addition, you may be liable to fines imposed by the Payment Shemes. 4 of web design ompany* N/A Contat Mr Ms Telephone no. *PaySquare may ontat the above-mentioned web design ompany in order to speed up the aount registration proess.
Paragraph 3.5 Physial store (please skip this paragraph if you ompleted Setion 2) 1 Does your Company operate a physial store in addition to an online store? Yes No (please proeed to paragraph 3.6) If you seleted Yes : Number of loations: 1 2-5 6-10 11-25 more than 25 2 What types of produts are sold in the physial store(s)? Paragraph 3.6 Seurity poliy 1 Are your Company s employees required to sign a nondislosure agreement? Yes No 2 Does your Company subjet potential employees to a bakground hek? Yes No If you seleted Yes : whih of the following does your Company hek (you may selet several options)? Personal details CV Certifiate of Good Condut Referenes Credit history 3 Has your Company taken any speifi measures to prevent unauthorised persons from gaining aess, or potentially gaining aess, to data-proessing systems or onfidential information? Yes No If you seleted Yes : what measures has your Company taken (you may selet several options)? Physial aess ontrol Seurity Awareness Training Logial aess ontrol/authorisation ontrol Written operating proedures Key poliy/key management Appointment of a ompliane/ontrol offier Clean desk poliy information seurity poliy. Inident registration Other (please speify) Paragraph 3.7 Data management and risk management 1 From whih Payment Servie Provider (PSP), or bank does your Company use an I online payment method? ABN AMRO BNG Dodata payments MultiSafepay Paybox Verotel Bukaroo B2U Esalion Ogone Rabobank Virtual XS Contat M F Telephone no. 2 Does your Company use the PSP s fraud module? Yes No* * Remote aeptane is subjet to additional risks. PaySquare strongly reommends that you limit these risks by using the fraud module provided by your PSP. A strong onfiguration in onjuntion with your PSP provides the best results. 3 Has your Company previously used the servies of another PSP? Yes No 4 Does your Company retain ustomer orders (e.g. IP address, routing, timestamp, et.)? Yes No 5 Does your Company use any risk management tools and tehniques? Yes No If you seleted Yes, please speify. (you may selet several options) Telephone ontat to reonfirm Chek or exlude from delivery to high-risk ountries Confirmation of order by e-mail Verifying IP address with delivery address Other (please speify) 6 Does your Company use any other, additional methods and/or systems to redue hargebaks and fraud? Yes No Please speify Additional Terms and Conditions for aeptane through the website: Your Company ertifies that it is familiar with, and will omply with, all appliable statutory provisions, partiularly with regard to distane selling, and guarantees full ompliane with these provisions.
Setion 4 Terms and Conditions and signatures Paragraph 4.1 Conditions of Use PaySquare SE, registered with the Duth Central Bank as being in possession of a liene as a payment institution sine 25 May 2010, the Stihting Third Party Fund PaySquare Foundation (hereinafter referred to as Foundation ) and your Company agree as follows: 1. Your Company agrees to PaySquare s aeptane poliy, and is aware that PaySquare may hange this poliy from time to time. PaySquare s aeptane poliy an be onsulted on www.paysquare.nl or www.paysquare.lu/en. 2. If your Company wishes to apply the Aount Contrat to several URLs or loations and has ompleted and enlosed the relevant Exel file to that end, your Aount Contrat applies only to those loations/urls approved by PaySquare. 3. After sreening, PaySquare determines whether or not the agreement will be onlude and, if so: based on whih form(s) of aeptane and for whih indiated loation(s) or URL(s). PaySquare reserves the right to amend and/or supplement these onditions. PaySquare also reserves the right to not enter into the agreement either in full or in part without being required to explain its deision or poliy in any manner whatsoever. 4. After your Company has signed the ontrat and after full or partial approval by PaySquare, your Company will reeive a opy of your Aount Contrat signed by PaySquare. If your Company has filled out the ontrat for several forms of aeptane, PaySquare an determine separately for eah form of aeptane whether or not the ontrat applies. PaySquare an also have the ontrat for the different forms of aeptane apply on different dates. 5. If the parties inlude additional provisions to this Aount Contrat in an attahment, these provisions will form an integral part of your Aount Contrat, and the attahment will be deemed to form an inextriable part thereof. If your Aount Contrat, after being extended with additional provisions/terms, is replaed with a new Aount Contrat, the attahments that formed part of your Aount Contrat will also be deemed to form part of the new Aount Contrat. Referenes made in attahments to the Aount Contrat will always refer to your Aount Contrat appliable at the time of reading, irrespetive of the date of signing of the attahment in question, unless, on signing the subsequent Aount Contrat, the parties expressly agree in writing that any previous attahments are exluded therefrom. 6. Your Company will deliver to PaySquare a minimum of the annual turnover listed in paragraph 2.2 for aeptane through the payment terminal and in paragraph 3.1 for aeptane through the website, as well as delivering to PaySquare the average transationamount in transations speified, where the share of orporate ards must not exeed the perentage in redit speified in paragraphs 2.2 and 3.1. 7. If your Company fails to omply with the above onditions, PaySquare will be authorised to adjust the agreed rates retroatively from the effetive date of the ontrat and to inrease the agreed ommission rates. 8. A minimum ommission harge of 4.50 per transation applies to manual transations involving sales slips. 9. The PaySquare General Terms and Conditions of Card Aeptane apply to this Aount Contrat. By signing your Aount Contrat, your Company expliitly onfirms that it reeived a opy of the PaySquare General Terms and Conditions of Card Aeptane in advane and is in agreement with the ontents thereof. The PaySquare General Terms and Conditions of Card Aeptane an also be onsulted on www.paysquare.nl. 10. Your Company guarantees that it is in possession of all appliable lienes required for the running of its ativities, and shall provide opies to PaySquare upon request. Your Company shall inform PaySquare diretly in writing of any event or legal deision that may affet his required lienes for arrying out his business ativities. 11. Your Company has organised its business operations suh that the law and other regulations are omplied with at all times in all transations. Your Company is not permitted to failitate transations unless a Aount Contrat has been onluded with PaySquare for this purpose. 12. Your Company expliitly agrees to PaySquare using the data provided by your Company and/or olleted by PaySquare in its internal information systems. On this basis, information an also be provided to Card Shemes, or members thereof, and to seurity and researh ompanies. In proessing your personal data, PaySquare omplies with all relevant legislationand regulations in the area of privay protetion. 13. The regulations of the Card Shemes are subjet to hange. PaySquare has no power over suh hanges. Where neessary, PaySquare will inform your Company of any hanges to these relevant regulations. 14. Your Company is aware of the risks in general and, in partiular, risks relating to payment with payment ardsthrough the website and knows that this an potentially lead to fraudulent transations and hargebaks. PaySquare requires that transations be ompleted in a 3-D Seure environment in order to minimise the risk of fraud and hargebaks. 15. Transations ompleted through your Company s website may only be ompleted on a Payment Servie Provider (PSP) s seure payment page. 16. Payment terminal transations may only be ompleted using an EMV-ertified payment terminal. 17. Your Company is aware of the provisions and regulations that apply to this ontrat, suh as in relation to hargebaks, seurity, fraud prevention, haks, data being ompromised and other breahes, onneted with the proessing of transation and/or ard details, as ommuniated on www.paysquare.nl and through other soures. www.piseuritystandards.org. 18. With a ertain perentage of hargebaks, your Company pays a ontribution per hargebak to PaySquare. This hargebak standard is published at www.paysquare.eu/hargebak. Please note: this standard is subjet to hange. So make sure to hek this standard regularly at www.paysquare.eu/hargebak. 19. MasterCard and Visa establish a maximum number of hargebaks permitted. These hargebak standards are published at www.paysquare.eu/hargebak. If the hargebak standard is exeeded, your Company shall ooperate fully with all measures proposed by PaySquare. Exeedane an result in penalties and fees. Please note: these standards are subjet to hange. So make sure to hek the hargebak standards regularly at www.paysquare.eu/hargebak. 20. Your Company will pay the annual registration fee if the Card Shemes require registration. 21. As an exeption to the PaySquare General Terms and Conditions of Card Aeptane, the aount statements for UnionPay and JCB transations will only be provided to your Company in hardopy format. 22. The Foundation s sole purpose is to reeive, temporarily manage and transfer funds to your Company and it will not provide any further servies under the Connetion Agreement. This obligation on the part of the Foundation to your Company is laid down in artile 4.2 of the General Terms and Conditions of Card Aeptane. By using the Foundation, all funds reeived are seured in aordane with Setion 3.29a of the Finanial Supervision At [Duth title: Wet op het finanieel toeziht]. No interest will be paid on the funds in the Foundation s bank aount.
Paragraph 4.2 Ultimate Benefiial Owner (UBO) All finanial institutions in Europe are legally obliged to identify any ultimate benefiial owner(s) and to verify these owners. This obligation is laid down in the Money Laundering and Terrorist Finaning (Prevention) At (Duth aronym: WWFT ). The ultimate benefiial owner is the natural person on whose behalf a business operates. An ultimate benefiial owner is also referred to by many finanial institutions as UBO, whih stands for Ultimate Benefiial Owner. An ultimate benefiial owner is a natural person who: has a stake of more than 25% of the apital or share apital of your Company, or an exerise more than 25% of the voting rights in your Company, or an exerise effetive ontrol within your Company (this refers to a person who is in harge in pratie), or is the benefiiary of more than 25% of the apital of a trust, or has speial ontrolling rights over 25% of more of your Company s apital (this refers to an individual with speial ontrolling rights that are established in, for example, the artiles of assoiation). If your Company is a partnership (suh as a general partnership, limited partnership or non-stok orporation), the ultimate benefiial owner is the natural person who: is entitled to a share of the partnership of more than 25% in the event of dissolution, or is entitled to a profit share of more than 25%, or in deision-making (about fundamental matters onerning the partnership), an exerise more than 25% of votes if the deision requires a majority vote, or an exerise effetive ontrol over the partnership (this refers to a person who is in harge in pratie). Fill in the details of the Ultimate Benefiial Owner(s) below. For speifi business operations, we may be required by law to request your Company for additional information. Any hanges to the details of the Ultimate Benefiiary Owner(s) must be reported to PaySquare within 7 working days. of birth Address Postode Country of birth Address Postode Country of birth Address Postode Country Your Company has no Ultimate Benefiiary Owner
Paragraph 4.3 s This Aount Contrat will replae your aount ontrat dated * * Complete only if appliable Your Company, lawfully represented by Your Company, if limited authorisation to sign Your Company, if limited authorisation to sign Your Company, if limited authorisation to sign Your Company, if limited authorisation to sign To be ompleted by PaySquare Signed for aeptane: At the payment terminal for the loation(s) indiated under 1.1 and any Extra loations in the Exel overview. Via the website for the URL(s) as indiated under 3.4 and any Extra URLs in the Exel overview. By post, phone or fax. PaySquare SE, lawfully represented by Petra Gerla CEO PaySquare Utreht Stihting Third Party Fund PaySquare Foundation *, lawfully represented by Floris van Kolfshoten Member of the Board Utreht * This foundation will hold the funds intended for you separately before paying them to you Paragraph 4.4 Attahments to be added (general) In the ase of the legal forms Vereniging (assoiation), Stihting (foundation) and/or Stihting Administratiekantoor (trust offie), the most reent artiles of that legal person Copy (or print sreen) of a reent aount statement for the bank aount number to whih PaySquare transfers your payments The aount name and number must be learly legible; amounts an be struk through Copy of passport of the authorised signatory/signatories, as speified in the artiles of assoiation (Belgian/Duth Chamber of Commere) Copies of bank statements from other Card Shemes for the past 3 months (if appliable, paragraph 1.4) Copies of hargebak statements showing reason odes for the past 3 months (if appliable, paragraph 1.4) Permit to run a business (if appliable, paragraph 1.2) Paragraph 4.5 Attahments to be added for E-ommere appliations (supplementary to paragraph 4.4) Copy of your Company s General TTerms and CConditions Proof of domain registration and/or ownership for all URLs you use (paragraph 3.4) Copy of the annual finanial statements of the past two years, signed by an auditor, or a opy of the business plan and an overview of the finanial expetations for the oming year, prepared by an auditor Please note: Please omplete all setions of your Aount Contrat and enlose all the required attahments (learly legible and with lear, high-quality pitures). We require this information in order to proess your appliation and to be able to hek whether it omplies with the appliable laws, the requirements of the ard shemes, and PaySquare s aeptane poliy. You an do this by e-mail to onnet@paysquare.nl or by post to: PaySquare SE, Postbus 30508, NL-3503 AH Utreht, The Netherlands. PaySquare SE, Chamber of Commere registration no. 30196418 3.1037 01 14