KZ

Вход в личный кабинет

freedombank.kz

salem@bankffin.kz

595

freedombank.kz

salem@bankffin.kz

595

Connection Questionnaire to
PUBLIC OFFER/AGREEMENT FOR THE PROVISION OF PAYMENT SERVICES IN THE FREEDOM PAY SYSTEM
No.______ dated _ _20___

Name of Organization/Merchant

Legal name

Trading name

Organization/Merchant details

Date and number of state registration

Type(s) of activity and code of the Common Classifier of Economic Activity (OKED)

BIN/IIN or tax registration number in the country of residence

Legal address

Actual address

Telephone

E-mail

Previous card acceptance experience (years, months)

Details of the license for the activities subject to licensing

Name of the authority that issued the license

Activity

Date of issue

Validity period

List of licensed activities

Web-site (URL)

Mobile app

Main activities

Country of primary business*

Description of all goods/services offered*

Estimated monthly turnover

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

Number

Minimum ______________
Average ____________________
Maximum ______________

freedombank.kz

salem@bankffin.kz

595

freedombank.kz

salem@bankffin.kz

595

Estimated number of transactions per month*

Forecasted average transaction/purchase amount (per month)*

Forecasted share of returns (cash) in the amount of merchant’s sales per month*

Web addresses of all merchant’s websites used for operations/sales *

Holder of registered owner of the merchant website domain names*

Presence of cross-links to other websites on the merchant page, including advertising banners*

Indicate the names of the websites on which the merchant advertises its website*

Payment page:

Merchant plans to*

Legal restrictions on the use of goods and services / Merchant’s website / Export restrictions*

Names of all service providers - legal entities that have access to transaction details*

Contact details*

Contact e-mail*

Contact telephone number*

Merchant’s clients are able to contact the Merchant*

Bank name*

BIC*

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

43

Merchant’s contact details for interactions in case of detection of suspicious / fraudulent activity*

Entering the buyer's bank card details through the Bank's platform.

Entering and processing the bank card details by the merchant itself (in this case, a certificate of the merchant’s compliance with PCI DSS standards is required)

a. provide subscription services (recurring payments) (yes/no)
b. use of a free trial subscription for its own products/services (yes/no)
c. sale products via the Internet only (yes/no)
d. enter the card details manually using a telephone (yes/no)
e. sale offline only (yes/no)

freedombank.kz

salem@bankffin.kz

595

freedombank.kz

salem@bankffin.kz

595

Beneficiary Code*

Bank account/Transit account*

BIN*

IBAN*

E-mail address for sending daily report on deposits to the account*

Details of the organization/merchant managers

Full name of the First Manager

Position

Citizenship

ID card/Passport No.

Issued by

Date of issue

IIN

Telephone

E-mail

Actual place of residence

Affiliation with public officials or persons related thereto (their spouses, close relatives, and representatives)

Details of shareholders/founders of the organization/merchant

Name/Full name of shareholder/founder

IIN/BIN or tax registration number in the country of residence

Ownership share, %

Residence

Description of all goods/services offered*

Details of beneficial owners

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

Place of registration/legal address

freedombank.kz

salem@bankffin.kz

595

freedombank.kz

salem@bankffin.kz

595

Actual place of residence

IIN or tax registration number in the country of residence

Ownership share, %

Residence

ID card/Passport No.

Issued by

Date of issue

Affiliation with public officials or persons related thereto (their spouses, close relatives, and representatives)

Details of the affiliated companies

Legal name

BIN

Legal address

1

2

3

4

5

6

7

8

9

10

11

12

Details of the affiliated companies

Payment acceptance:
Second-tier bank cards

Service for making payments to second-tier bank cards of RK

Service for accepting payments from balances of mobile operators

11

12

13

14

3.5%, 25 tenge minimum

1.9%, 300 tenge minimum

5%

The information and details contained herein are complete and reliable.

You have read and understood the terms of the Public Offer/Agreement for the provision of payment services in the Freedom Pay System, set out on the official website of the Organization https://freedompay.kz/kz, as well as the following rules:

"Rules for coordination of the work/service completion certificates";
"Rules for compliance with legislation of the Republic of Kazakhstan On combating the legalization (laundering) of proceeds from crime/financing of terrorism/financing of proliferation of weapons of mass destruction”;
“Rules for International Payment System and conditions for the “Chargeback” procedure, specified on the website of the Organization ____________, and further in the text of the Public Offer/Agreement for the provision of payment services, which are an integral part hereof, and you express full consent with and acceptance of them, as well as mandatory compliance during the period of payment services to be received from the Organization;

You have read and understood the Rules of the "Freedom Pay" e-money system _____________ in case of receiving payment services using e-money specified on the website of the Organization _________________________, and express full consent with and acceptance of the terms, as well as mandatory compliance during the period of payment services to be received using e-money through the Organization's System.
You have received the appropriate access and made technical settings to connect your personal account.

By signing the Questionnaire, you hereby confirm that:

freedombank.kz

salem@bankffin.kz

595

freedombank.kz

salem@bankffin.kz

595

Opinion

Opinion of Security Group

MСС (Merchant Category Code)

МСС and tariff check

Positive/Negative (please underline)

Assigned by: FULL NAME DATE

Checked by: FULL NAME DATE

Appendix to the Connection Application

Changes in the Merchant’s details

The Merchant’s representative shall submit the following documents to the Bank:

1. Changes in the name of the legal entity:
- Cover letter from the Merchant in free form
- Name change decision (a copy certified by the head of the Merchant)
- Order to destroy the old seal and approve a new one (a copy certified by the head of the Merchant)
- New edition of the Articles of Association (a copy certified by the head of the Merchant)

2. Changes in the address:
Changes in the legal address:
- Cover letter from the Merchant in free form
- Address change decision (a copy certified by the head of the Merchant)
- Rental agreement (a copy certified by the head of the Merchant)
- If the address in the Articles of Association has changed, then a new edition of the Articles of Association, or amendments to the Articles of Association (a copy certified by the head of the Merchant)
Changes in the actual address:
- Cover letter from the Merchant in free form
- Rental agreement at new actual address (a copy certified by the head of the Merchant)

3. Changes in the Merchant’s management:
- Cover letter from the Merchant in free form
- General Director change decision (a copy certified by the head of the Merchant)
- Passport of the new General Director (a copy certified by the head of the Merchant)

Completion date ______ __ 20___.

Stamp Here

_ _ _ _ _ _ _ _ _ _ _ _ _ _ / _________________/

_______________ / _________________/

Stamp Here

General Commission

Descriptor name

FFPAY*

freedombank.kz

salem@bankffin.kz

595

freedombank.kz

salem@bankffin.kz

595

4. Changes in the composition of the Merchant’s founders
- Cover letter from the Merchant in free form
- Decision on the participant’s resignation/affiliation (if available) (a copy certified by the head of the Merchant)
- Questionnaire with details of the new beneficiary
- If the participant is a non-resident, a form of self-certification as the beneficial Owner, a document confirming the ultimate beneficiary (either a trust declaration, or a memorandum, or other documents apostilled and issued by authorized bodies of the country of its registration with a translation into Russian; this document must contain relevant information on the ultimate beneficiary).
- TIN (tax number) of the individual ultimate beneficial owner and a document confirming this number.

5. Changes in the activities, type and kind of goods and services being sold
- Cover letter from the Merchant in free form
- Decision on changing the OKVED code (if available) (a copy certified by the head of the Merchant)

6. Changes in the bank details
- Cover letter from the Merchant in free form, signed by one of authorized managers with preliminary approved right of signature (signature card held in the Bank)

7. Addition of a new Merchant’s store address
Application for equipment (via the bank's internal system)

8. Changes in the forecasted turnover specified in the initial application–questionnaire from the Merchant
- Cover letter from the Merchant in free form
- Original cover letter shall be sent to the Bank (scanned copy thereof may be sent to the following e-mail address _________________________ in advance).