Request an offer

Distance business
We will gladly provide you with a non-binding offer. Simply complete the form below and will contact you right away.
Company information

9-digit merchant number
(if you are already one of our customers)

Company name: *

Address: *

P.O. Box:

Postal code / City: *

Contact person: *

Ms. | Mr.

Phone: *

Fax:

Internet address:

E-Mail: *

Sector: *

(e.g. Hotel)

Form of business: *

Other business form: (*)

Branches:

Locations: *

CH CH & abroad Abroad

Association member:

(e.g. Minotel)

Business registry no.: (*)

Business registry entry since (date): (*)

If you already know which contract you wish to enter into with us, then please answer the following questions:

Payment mode:

MasterCard
Visa
Diners / Discover
Maestro

	Mail/Phone-Order (order per telephone, letter or fax)
	Sales over the Internet ( Secure E-Commerce MasterCard / Verified by Visa ) The shop is / will be found at: (*) Your payment system provider We are active in the adult content, gambling or multilevel marketing sector (Tip: Special conditions apply to these types of businesses)

Comments:

To be able to provide you with the most comprehensive offer possible, we ask you to please also answer the following questions:

The expected turnover with MasterCard/Visa/Maestro is more then CHF 50'000.- per year? *

Yes No

The average amount per transaction is more then CHF 20.-? *

Yes No

Are you interested in a credit notice?
(** fees may occur)

E-mail ** A Mail ** B Mail ** none

DCC Dynamic Currency Conversion
Foreign currencies

Delivery	Reimbursement
		EUR
		USD
		other:

The questions marked with * are mandatory.