Primary Authorized User
Full Name*

Phone Number*

Your Email*

Residential Address*

Date of Birth*

Facebook URL (eg.https://facebook.com/abcshop/)*

Facebook ID*

ID Type*
National IDPassportDriver’s License

ID Number*

ID Issuing Country*
SingaporeAngolaAntigua and BarbudaArgentinaAzerbaijanBahrainBangladeshBelarusBelgiumBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongoCosta RicaCroatiaCubaCyprusCzech RepublicDjiboutiDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaGabonGambiaGeorgiaGermanyGhanaGreeceGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIndiaIndonesiaIranIraqIsraelIvory CoastJordanKazakhstanKenyaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMauritaniaMauritiusMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNepalNigerNigeriaNorth KoreaNorth MacedoniaOmanPakistanPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSlovakiaSloveniaSomaliaSouth AfricaSouth KoreaSpainSri LankaSudanSurinameSwazilandSyriaTaiwanTajikistanThailandTunisiaTurkeyUgandaUkraineUnited Arab EmiratesUruguayVenezuelaVietnamZambiaZimbabwe

Proof of Identity*

Primary Authorized User Proof of Address*

Below details are required for Payment Gateway registration.
Company Information
I am a Financial institution registered outside of the US (requires additional compliance information)I plan to collect or disburse funds in the United States and am a registered entity in the United States

I would like to use Rapyd for
Select an optionCollectionsDisbursementBoth

Official Business Name*

Entity Type*
Select an optionPrivatePublic-ListedTrustGovernmentAssociationCharity or Non-profitSole proprietorPartnership

Street Address*

City*

Postal Code*

Years in Business*

Country of Registration*
SingaporeAngolaAntigua and BarbudaArgentinaAzerbaijanBahrainBangladeshBelarusBelgiumBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongoCosta RicaCroatiaCubaCyprusCzech RepublicDjiboutiDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaGabonGambiaGeorgiaGermanyGhanaGreeceGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIndiaIndonesiaIranIraqIsraelIvory CoastJordanKazakhstanKenyaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMauritaniaMauritiusMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNepalNigerNigeriaNorth KoreaNorth MacedoniaOmanPakistanPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSlovakiaSloveniaSomaliaSouth AfricaSouth KoreaSpainSri LankaSudanSurinameSwazilandSyriaTaiwanTajikistanThailandTunisiaTurkeyUgandaUkraineUnited Arab EmiratesUruguayVenezuelaVietnamZambiaZimbabwe

Business Incorporation Number*

Tax Number (TAX ID/VAT/IVA)

Business Phone Number*

Description of Business*

Industry*
E-Commerce - Digital GoodsE-Commerce - MarketplaceE-Commerce - Retail, EducationEngineering, Food & BeverageFinancial Services (including Insurance, Fintech, FX)Food DeliveryNetwork MarketingOnline Travel Agencies (OTA)OthersReal estateRide-hailingTechnologyTelcoVideo Streaming

Services Provided*
Veterinary services - 742 Veterinary ServicesLandscaping services - 780 Horticultural Services, Landscaping ServicesGeneral Contractors - 1520 General Contractors-Residential and CommercialA/C and heating contractors - 1711 Air Conditioning Contractors - Sales and Installation, Heating Contractors - Sales, Service, InstallationPrinting and publishing - 2741 Miscellaneous Publishing and PrintingTransportation - 4789 Transportation Services, Not elsewhere classified)Telecom equipment - 4812 Telecommunications Equipment including telephones salesTelecom services - 4814 Fax services, Telecommunication ServicesMoney orders - 4829 Money Orders - Wire TransferUtilities - 4900 Electric, Gas, Sanitary and Water UtilitiesRetail - 5045 Computers, Computer Peripheral Equipment, SoftwareRetail - 5399 Misc. General MerchandiseRetail - 5611 Men’s and Boy’s Clothing and Accessories StoresRetail - 5712 Furniture, Home Furnishings, and Equipment Stores, Except AppliancesRetail - 5734 Computer Software StoresRetail – 5965 Direct Marketing - Catalog and Catalog and Retail MerchantRetail - 7298 Health and Beauty ShopsMedical devices - 5047 Medical, Dental Ophthaimic, Hospital Equipment and SuppliesPrecious Stones and Metals, Watches and Jewelry - 5094 Precious Stones and Metals, Watches and JewelrySupplements or nutraceuticals - 5122 Drugs, Drug Proprietors, and Druggist’s SundriesAuto parts and accessories - 5533 Automotive Parts, Accessories StoresCar sales - 5599 Miscellaneous Auto DealersHome electronics - 5732 Electronic SalesCaterers - 5811 CaterersOther food and dining - 5812 Eating places and RestaurantsFood and drink - 5814 Fast Food RestaurantsBooks - 5815 Media, Books, Movies, MusicGames - 5816 GamesApps - 5817 Applications (Exclude Games)Digital Products - 5818 Large Digital GoodsPharmacies or pharmaceuticals - 5912 Drug Stores and PharmaciesJewelry Stores, Watches, Clocks, and Silverware Stores - 5944 Watch, Clock, Jewelry, and Silverware StoresTelemarketing - 5966 Direct Marketing - Outbound Telemarketing MerchantLead Generation - 5969 Direct Marketing - Not Elsewhere ClassifiedTobacco or cigars - 5993 Cigar Stores and StrandsGrocery stores - 5999 Miscellaneous and Specialty Retail StoresVirtual currencies - 6051 Non-Financial Institutions - Foreign Currency, Money Orders (not wire transfer) and Travelers ChequesSecurity brokers or dealers - 6211 Security Brokers/DealersInsurance - 6300 Insurance Sales, Underwriting, and PremiumsTravel and lodging - 7011 Lodging - Hotels, Motels, Resorts, Central Reservation Services (not elsewhere classified)Laundry or cleaning services - 7210 Laundry, Cleaning, and Garment ServicesSalons or barbers - 7230 Barber and Beauty ShopsDating services - 7273 Dating and Escort ServicesDebt reduction services - 7277 Counselling Service - Debt, Marriage, PersonalMassage Parlors - 7297 Massage ParlorsCredit counselling or credit repair - 7321 Consumers Credit Reporting AgenciesPhotography studios - 7333 Commercial Photography, Art and GraphicsAssisted living - 7361 Employment Agencies, Temporary Help ServicesComputer repair7379Consulting - 7392 Management, Consulting, and Public Relations ServicesCar rentals - 7512 Car Rental Companies (Not Listed Below)Auto services - 7538 Automotive Service ShopsMusicians, bands, or orchestras - 7929 Bands, Orchestras, and Miscellaneous Entertainers (Not Elsewhere Classified)Event ticketing - 7991 Tourists Attractions and ExhibitsBetting or fantasy sports - 7995 Betting (including Lottery Tickets, Casino Gaming Chips, Off-track Betting and Wagers at Race Tracks)Recreational camps - 7996 Amusement Parks, Carnivals, Circuses, Fortune TellersCountry clubs - 7997 Membership Clubs (Sports, Recreation, Athletic), Country Clubs, and Private Golf CoursesEntertainment and recreation - 7999 Recreation Services (Not Elsewhere Classified)Doctors and physicians - 8011 Doctors and Physicians (Not Elsewhere Classified)Dentists and orthodontists - 8043 Opticians, Opticians Goods and EyeglassesNursing or personal care facilities - 8050 Nursing or personal care facilitiesHospitals - 8062 HospitalsMedical Organizations - 8071 Medical and Dental LaboratoriesMedical services - 8099 Medical Services and Health Practitioners (Not Elsewhere Classified)Attorneys and lawyers - 8111 Legal Services and AttorneysElementary or secondary schools - 8211 Elementary and Secondary SchoolsColleges or universities - 8220 Colleges, Junior Colleges, Universities, and Professional SchooldVocational schools or trade schools - 8249 Vocational Schools and Trade SchoolsEducation - 8299 School and Educational Services (Not Elsewhere Classified)Child care services - 8351 Child Care ServicesCharities or social service organizations - 8398 Charitable and Social Service OrganizationsCivic, fraternal, or social associations - 8641 Civic, Fraternal, and Social AssociationsPolitical organizations - 8651 Political OrganizationsReligious organizations - 8661 Religious OrganizationsMembership organizations - 8699 Membership Organizations (Not Elsewhere Classified)Testing laboratories - 8734 Testing Laboratories (non-medical)Accounting, auditing or tax prep - 8931 Accounting, Auditing, and Bookkeeping Services

Company URL (if any)

Approx. Annual Revenue in USD*

Average Transaction Value*

Is the company engaged directly or indirectly in any cryptocurrency activities?*
YesNo

Is the company engaged directly or indirectly in any Gambling activities?*
YesNo

Company Incorporation Documents (of the last 3 months Bizfile)*

Capital Table/Organizational Chart (Please ignore if you are a sole proprietor.) Template Download

Please upload your Bank Statement* (within last 6 months of Bank Statement)

Proof of Company Address* (Rental agreement, Certificate of Incorporation, or a utility bill under the company’s name)

Shareholders Information
The number of individuals or companies with at least a 25% stake in the company
01234

CEO Details
CEO Full Name (Have a minimum of 25% shareholding)

CEO Date of Birth

CEO Residential Address

ID Issuing Country
SingaporeAngolaAntigua and BarbudaArgentinaAzerbaijanBahrainBangladeshBelarusBelgiumBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongoCosta RicaCroatiaCubaCyprusCzech RepublicDjiboutiDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaGabonGambiaGeorgiaGermanyGhanaGreeceGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIndiaIndonesiaIranIraqIsraelIvory CoastJordanKazakhstanKenyaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMauritaniaMauritiusMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNepalNigerNigeriaNorth KoreaNorth MacedoniaOmanPakistanPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSlovakiaSloveniaSomaliaSouth AfricaSouth KoreaSpainSri LankaSudanSurinameSwazilandSyriaTaiwanTajikistanThailandTunisiaTurkeyUgandaUkraineUnited Arab EmiratesUruguayVenezuelaVietnamZambiaZimbabwe

Add CEO details (A copy of front and back IC to prove name and address.)

CFO Details
CFO Full Name (Have a minimum of 25% shareholding)

CFO Date of Birth

CFO Residential Address

ID Issuing Country
SingaporeAngolaAntigua and BarbudaArgentinaAzerbaijanBahrainBangladeshBelarusBelgiumBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongoCosta RicaCroatiaCubaCyprusCzech RepublicDjiboutiDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaGabonGambiaGeorgiaGermanyGhanaGreeceGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIndiaIndonesiaIranIraqIsraelIvory CoastJordanKazakhstanKenyaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMauritaniaMauritiusMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNepalNigerNigeriaNorth KoreaNorth MacedoniaOmanPakistanPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSlovakiaSloveniaSomaliaSouth AfricaSouth KoreaSpainSri LankaSudanSurinameSwazilandSyriaTaiwanTajikistanThailandTunisiaTurkeyUgandaUkraineUnited Arab EmiratesUruguayVenezuelaVietnamZambiaZimbabwe

Add CFO details (A copy of front and back IC to prove name and address.)

1) Are any of the shareholders, partners, directors, officers or legal representatives Politically Exposed Persons (PEPs)?
YesNo

2) Has the Company or any of its principals been subject to any criminal investigations, law enforcement proceedings, regulatory inquiries, convictions, consent decrees or similar actions by any government agencies within the past five (5) years?
YesNo