POS Merchant Registration Form

NOTE: Please fill in the application form in full. Incomplete application forms will be rejected.

Program *

Referral Code: (optional)

A. Company Details

Trading Name *

New Business Registration Number *

Type of Business

Company Address *

City *

Postal Code *

State

B. Business Information

Contact person details

Full Name *

Designation *

Contact No *

Email Address *

C. Details on Company Bank Account

Bank Name *

Account No *

Account Holder Name *

Contact Person (Finance) *

D. Document Submission Checklist

All Merchant Types

Identity Card (MyKad) *

Latest Bank Statement Header *

Signboard Picture *

Building Picture *

Entrance Picture *

Interior Right Picture *

Interior Left Picture *

Payment Counter Picture *

E. Commercials

Average Transaction Amount (RM)

I/We hereby confirm that all information provided in this application is true, accurate and complete.
I/We authorise HARI2MAU REWARDS SDN BHD (HARI2MAU) to process this application and communicate with me/us regarding it.
I/We understand that HARI2MAU reserve the right to approve or reject this application without providing any reason.
I/We further authorise HARI2MAU to verify the information/documents given by me/us from any source (including third parties and regulatory bodies).
HARI2MAU shall have the right to request for further information to verify the user account details or merchant account, and has the right to access account information at any time.
I/We agree to be bound by the HARI2MAU Merchant Terms of Service at the date of this Application Form.
I/We have understood all requirements indicated by HARI2MAU and will ensure that total compliance is met at all times.
Refund/Void: Merchant needs to notify in writing to info@harimaurewards.com. Void can only be performed on the same day as the transaction.
Termination/Discontinuation: Merchant needs to notify in writing to info@harimaurewards.com. Termination will be carried out 1 week after receipt of written notice.

I/We have read and agree to the terms and conditions above.*

Authorized Signature*
(draw or upload)

Name *

Designation *

Date *

Official Company Stamp *

F. Additional Outlets

Outlet Name

Address

PIC Name

Designation

Contact Number

Email Address

Operation Hours

Day

Time

Closed