Pay component request EN

Pay component request

    Agent code
    If you don't have a code you can ignore this field

    The information Synkrony collects about your business helps us comply with the requirements of regulators and financial partners
    (Fields marked with * are mandatory)

    Company email address*
    Phone number

    Business type:

    Choose the legal nature of your company or association

    Please, specify other*:
    Individual Business data:
    Company data
    Non-profit organization data
    Legal business name*
    VAT number*
    Employer/Business identification number*

    Registered business address

    Please, specify other:

    Do you sell physical goods?

    Product description

    Provide a company registration report/document from which the entire list of business owners and relative shares is visible (the document shall not be older than 2 months)
    VAT registration certificate

    Acconsento al trattamento dei dati personali ai sensi del Regolamento Europeo 2016/679 (GDPR) and DLgs 30.6.2003, n.196. Privacy Policy

    By confirming the form you send your main data to our administration.
    A person in charge will contact you for the data necessary to enable the service.