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.