iPAY88 MYR GATEWAY APPLICATION FORM

NOTE: Please fill up this service application form IN FULL! Incomplete application will not be processed.

A. TYPE OF APPLICATION
Type of Application New Merchant iPay88 Existing Merchant
B. GENERAL INFORMATION
1. E-Commerce
Online Banking PayPal BNPL
Payment Option
Credit Card E-Wallet

SME SOHO Corporate

Merchant Type (Package Plan)
Others

A/C Manager (Sales Person) Keith Chew Reseller

C. COMPANY PROFILE
Company Name MY MOM COLLECTION
Company Registration No. 201203086330 MSIC Code JM0620973-U
SST Registration No. Tax Identification No. (TIN) IG 27139111010
Type of Business Sole Proprietor Partnership Sdn. Bhd. Bhd. Others

Company Address NO 26-1, JALAN NIAGA 14,

81900 KOTA TINGGI JOHOR
Office Contact No. 6017-7992116 Company Email Address pemburutopi@gmail.com
D. CONTACT PERSON
Transaction Notification Technical & Integration
Name MOHAMAD FAISAL Name MOHAMAD FAISAL
Designation Designation
Email Add. pemburutopi@gmail.com Email Add. pemburutopi@gmail.com
Contact No. 6017-7992116 Contact No. 6017-7992116
Announcement/Maintenance Alert/Fraud & Dispute Sales & Marketing
Name Name
Designation Designation
Email Add. Email Add.
Contact No. Contact No.
Finance & Settlement E-Invoicing
Name Name
Designation Designation
Email Add. Email Add.
Contact No. Contact No.
E. DETAILS ON E-COMMERCE BUSINESS
URL / Website Address https://mymomcollection.myshopify.com
Target Market (by Country)

Type text here

Products Sold / Service Offered MUSLIMAH CLOTHING

Current Monthly Sales or Forecast Products/Services Price Range

(MYR) 50000 (MYR) 59
Is Sales Receipt/Invoice issued? Yes No Shopping Cart System used
YES
Is proof of delivery obtained? Yes No Do you have a refund policy? Yes No

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 F. DETAILS ON COMPANY BANK ACCOUNT
Bank Name MAYBANK Account No. 551070420537
Account Holder Name MY MOM COLLECTION
Bank Branch KOTA TINGGI, JOHOR
Swift Code (if any)
iPay88 Settlement Notification being
sent to
G. DETAILS ON CUSTOMER SERVICE & EMAIL NOTIFICATION
Email Notification for Successful Transaction to be sent to
Customer's Email
Merchant's Email (please state the merchant's email)
___________________________________________________________
H. ACKNOWLEDGEMENT
1. I / We confirm that the information given herein by me is true and correct. I understand & must provide written notice to iPay88
(M) Sdn Bhd (iPay88) on any change of information as bound by this application.
I / We further agree that iPay88 reserves its rights not to accept this change without providing any reason and may lead to
termination of the Merchant Agreements.
2. I / We understand that iPay88 may decline this application without giving any reason whatsoever.
3. I / We have read, understand & be bound to all clauses stated in the Merchant Agreement as spelled out and published at
https://www.ipay88.com/merchant-agreement/ and acknowledge that these clauses may be modified by iPay88 from time to
time. I shall always keep myself updated on any modified clauses by visiting the above URL.
4. I / We hereby authorise iPay88 to obtain any credit information related to my / our company credit application from the credit
reporting agencies, credit bureau and any other bodies or authorities as iPay88 may deem fit under any applicable law,
regulation, guidelines, regulatory requirement or directive in respect of this application.
5. I / We hereby give consent to iPay88 for disclosure of information relating to my / our personal and / or company's particulars,
dealings and credit standing which may be in iPay88 possession in connection with this application or any other facilities
which I / We and our company may have obtained from iPay88 to the credit reporting agencies, credit bureau and any other
bodies or authorities as iPay88 may deem fit under any applicable law, regulation, guidelines, regulatory requirement or
directive which may at the material time be conducting a credit check on me / us and our company.
6. I / We agree to accept the Fee, Rate & Service Charge that have been offered by iPay88 as per Annexure(s) attached and
iPay88 reserves its rights to change the said Fee, Rate & Service Charge by giving one 30 days written notice.
7. I / We agree certain transaction amount shall be kept by iPay88 (collectively "Security Deposit (Holdback)").
This amount will be used to refund the credit card member if the card member disputed the transaction successfully.
8. I / We agree to responsible fully for any disputed amount received.
9. I / We confirm & agree not to make any change and/or new add in of Product(s) sold/Services(s) offered online on my/our
website and/or URL/Domain that is different from this application. In the event of change and/or new add in of Product(s)
Sold/Services(s) offered online and/or URL/Domain, I / We must give thirty (30) days prior written notice to iPay88 and
understand this request shall be deemed as a new application.
iPay88 shall at its sole discretion to reject or accept this new application by revising the Fees, Rates, Service Charges, Terms
and Conditions offered herein.
10. I / We further undertake that I / We shall not:
i. Upload the prohibited products and services as stated in Appendix B at my / our website; and/or
ii. Involve in any business activities as stated in Appendix B e.g. Penny Auction / bidding, etc., unless prior written approval has
been granted by iPay88 with additional Fees, Rates, Service Charges, Terms & Conditions, whichever is applicable.
11. I / We acknowledge and covenant that I / We shall not deal directly with the Bank and/or Card Brand Associations.
12. I / We agree to accept all Terms and Conditions that accompany the usage of iPay88 Service(s). These Terms and Conditions
are subjected to be revised by iPay88 and I will be notified in a manner as iPay88 deems appropriate.
13. I / We have read and accepted the terms in iPay88 Privacy Policy as spelled out and published at
https://www.ipay88.com/privacy-policy/.

I / We consent to disclose my/our Personal Data to receive marketing and promotional through SMS, e-mails,
telemarketing call, mailers, brochures and any other mode of communications from iPay88 and/or related and/or
associate company with the iPay88 Group, iPay88’s business partners or which has contractual relationship with iPay88.
In the event that I / We do not wish to receive such marketing and promotional calls and materials, I may opt out at any
time by calling iPay88 Customer Care Line at +603 2261 4668 or email to support@ipay88.com.my.

Authorised Signature

Name MOHAMAD FAISAL Official Company

Stamp
Designation
Date 10 FEB 2025
iPay88 Malaysia
Suite 2B-20-1, 20th Floor, Block 2B, Plaza Sentral
Jalan Stesen Sentral 5, 50470 Kuala Lumpur
Phone: +60322614668 Fax: +60322614663
Email: support@ipay88.com.my
MYRGATEWAY/Ver17/20240304
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