Register | iVeri Payment Technologies

Name and Surname *

Phone/Mobile *

Email *

Job Position/Title

Company Name *

Trading As

Country of Business Registration

Company Reg. No.

VAT Number

Industry

Nature of Business

Street

City

Country

Please specify *

Does the business form part of a group or holding company?

Yes

No

Company Name *

Company Reg. No.

Payment Methods

Instore

Online

Instore & Online

No. of Sites

No. of Lanes

POS Provider

Channels

Website

Mobile app

Other

Shopping Cart

How many transactions does the business process per month?

< 1,000

1,000 - 10,000

10,000 - 100,000

100,000+

What is the monthly turnover?

< R1m

R1-10m

R10m+

Accounts/Billing

Marketing

Sales

Project

Technical

Where did you hear about us?

Have you already liased with someone?

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No

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I have read, understood and agree to the Terms And Conditions.

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I acknowledge that the details and information provided are true and correct to the best of my
knowledge, and that I am authorised to submit this request on behalf of the company.

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