Post on 28-Apr-2015
description
Aplikasi ini menjadi satu kesatuan yang tidak terpisahkan dari syarat dan kondisi yang tercantum pada perjanjian kerjasama (PKS).
Merchant menyetujui keterikatan kondisi yang berlaku dalam aplikasi serta lampiran didalamnya.Aplikasi ini hanya dapat direvisi atau
dirubah oleh wakil yang ditunjuk secara tertulis dari kedua belah pihak . Aplikasi dan lampiran ini merupakan persetujuan akhir
menggantikan penawaran yang ada sebelumnya meliputi pesanan pembelian maupun tagihan terkait.
Nama Perwakilan :
Jabatan :
Alamat Email :
Nomor Telephone :
Merchant Authorized Signatory DOKU Authorized Signatory
INTERNET BANKING DOKU
Nama Perusahaan
Alamat Perusahaan
Nomor Telephone Nomor Fax Website
Jenis Usaha
Penerbangan Elektronik Donasi Lain-lain : ____________________
Tour / Travel Retail MLM
A. DATA BISNIS MERCHANT
LEMBAR PERSETUJUAN LAYANAN PEMBAYARAN INTERNET BANKING DOKU
No PKS DOKU : Jangka Waktu :
INTERNET BANKING
KlikBCA Others :
MANDIRI
BIAYA DOKU BANK’s
Transaksi : Rp.
Tanggal Perjanjian : Jangka Waktu :
B. DATA LAYANAN
C. PELAKSANAAN BISNIS
www.doku.com
merchant logo
MERCHANT DOCUMENT
KTP / KITAS / Passport
SIUP / Certificate of Residence
Tax Identification Number (NPWP)
Deed of Establishment & the Changes
Lembar Pengesahan Men-Kehakiman
Rental or Lease Agreement / Contract / Ownership
Merchant Request Form
Site’s Photo (front view, store signage, o�ce view)
Payment Account (Bank, Branch, Account No.)
Form SP Debet (attached)
E-Commerce Website
Statement for EDU* availability
E-Commerce Standard Operation Procedures (SOP)
Additional Document : IATA / ASITA for Tour & Travel’s Merchants SP Debet for merchant HP, Jewellery, Computers
*EDU : Early Detection Unit. Merchant’s unit/sta� that check all incoming transactions for the card holder genuity.
DOCUMENTS INDIVIDUAL,PD,UD PT, CV, FIRMA,YAYASAN CHECK DOKU
LEGAL DOCUMENTS
EXCEPTION DOCUMENTS
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KTP / KITAS / Passport
SIUP / Certificate of Residence
Tax Identification Number (NPWP)
Deed of Establishment & the Changes
Lembar Pengesahan Men-Kehakiman
Rental or Lease Agreement / Contract / Ownership
Merchant Request Form
Site’s Photo (front view, store signage, o�ce view)
Payment Account (Bank, Branch, Account No.)
Exchange with Surat Pernyataan Pengurusan from Merchant (sign by Merchant & Stamp/Materai).
Exchange with Surat Pernyataan Pengurusan from Merchant (sign by Merchant & Stamp/Materai).
Exchange with Surat Pernyataan Pengurusan from Merchant (sign by Merchant & Stamp/Materai).
Exchange with Surat Pernyataan Pengurusan from Merchant (sign by Merchant & Stamp/Materai).
Exchange with Surat Pernyataan Pengurusan from Merchant (sign by Merchant & Stamp/Materai).
Exchange with explanation letter from Merchant.
EXCEPT for Merchant that located in representatifMalls (NON ITC)
Priority BANK’s Saving Account
DOCUMENTS EXCEPTION INFORMATION
MERCHANT APPLICATION
Company Registered Name Company Trading Name NPWP No.
URL
Address
City State Postal Code
Ownership Type (Please circle)
1. Private Corporation 3. Government 5. Non - Profit
2. Partnership 4. Education
Place Incorporated Month / Year Started No. of Employees
O�ce No. Customer Service No. Contact Person
E-Mail Address
Business Premises (Please circle) Occupied since ( mm / yyyy ) Lease Expires ( mm / yyyy )
1. Owned 2. Rented
Landlord Name Contact Name Contact Number
MERCHANT BUSINESS INFORMATION
APPLICATION
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Business Type (Please circle)
1. Retail Swipe 3. Mail Order & Telephone Order 5. Other
2. Transfer 4. Internet
Product Type (Please circle)
1. Airlines 7 . MLM / Subscription 13. Property
2. Land Transportation 8 . ISP 14. Education
3. Hotel 9 . Advertisement 15. Government
4. Travel Agent 10. Digital Content 16. Charity / Donation
5. EO / Conference 11. Electronics 17. Exports
6. Insurance 12. Retail 18. Others :
Average Ticket Minimum Ticket Maximum Ticket
Rp Rp Rp
Expected Monthly CC Sales
Rp
Types of Sales 1. Business to Business 3. Wholesale
(Please circle) 2. Business to Cunsumer 4. Distributor
Delivery Policy after Transaction 1. Immediate 3. 1-3 days
(Please circle) 2. Within 24 hours 4. 4-7 days
Refund & Return Policy 1. Immediate 3. After 30 working days
(Please circle) 2. After 14 working days 4. Others
BUSINESS BACKGROUND INFORMATION
Website URL :
Website hosted in
A. Indonesia. City : B. Foreign. Country :
Type of hosting
A. Shared Server B. Dedicated Server C. Co-location
Hosting Company Name : ISP Company used for Web Server :
Server Platform :
A. Windows B. Linux C. FreeBSD D. Other
Language Used :
A. PHP B. ASP/.NET C. Java D. Other
Database Used :
A. MySQL B. MSSQL C. Postgresql D. Other
SSL Certificate used:
A. Verisign B. Thawte C. None D. Other
Shopping Cart used:
A. OSCommerce B. VirtueMart C. In-House D. Other
Website Development
A. In-House IT B. 3rd Party. Company Name :
IT Contact :
Name :
E-Mail :
Phone :
IM :
MERCHANT SERVER
*For Merchant without Mall / Web Server(s), DOKU would like to o�er or assist you with a solution. Please Contact us.
WEB SERVER INFOMATION
APPLICATION (SECTION 1) ( FOR MERCHANT WITH EXISTING MALL/WEB SERVER )
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WEB DEVELOPER INFORMATION
CREDIT CARD MDR OTHERS RATES
BNI VISA / MasterCard PAY PAL
CITIBANK VISA / MasterCard T-CASH
MANDIRI VISA / MasterCard E-MONEY
A. Registration + Account Application (non-refundable) : Rp. 2.000.000,00
B. Setup Fee (Integration) : Rp.
C. Monthly Getaway Subscription : Rp.
D. Transaction Fee VISA / MasterCard : Rp.
Billing Terms and Conditions:- Minimum Contact Terms : 24 Months from the activation date of MID/TID issued by BANKS and/or DOKU- A & B are payable after signing the application from- C is application throughout the duration of the contract with no exceptions unless agreed by DOKU management- Penalty for late payment and early termination of contract will apply as per Clause 3 "Biaya" in the Merchant Agreement
This Application should be read together with the Terms and Conditions found in the Merchant Agreement. The Merchant agrees to be bound by the Terms and Conditions incoperated by reference herein and attached hereto. This Application shall only modified or amended in writing signed by the authorized representative of both parties. This Application and attached Merchant Agreement supersedes any representation, promised, proposals and communication (oral & writen) and prevails over any additional or conflicting terms contained within any purchase order, invoice of other similar document for these Services.
FEES
1. ACQUIRING BANKS & BRANDS
2. DOKU SERVICES
Application (Section 2)
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Name of Authorized Signatory :
Signature of Applicant / Authorized Signatory DOKU Authorized O�cer
Merchant Company Stamp(if applicable) DOKU Company Stamp
Date : Date :
Sales Manager :
Manager’sSignature :
Sales Executive /Reseller Name :
Signature /Company’sSignature :
(If applicable)
For Doku Use Only For Sales Exec and Reseller Use Only