payment service provider switching form existing payment service provider (psp) new payment service

Download Payment Service Provider switching form Existing Payment Service Provider (PSP) New Payment Service

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  • Payment Service Provider switching form

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    Existing Payment Service Provider (PSP) New Payment Service Provider (PSP) as of

    Name of the PSP Name of the PSP

    Account ID Account ID

    Contract termination date Contract starting date/ // /

    Da ta

    P SP

    I hereby confirm that the contract with the current Payment Service Provider was terminated with the proper period of notice.

    The Merchant’s legal signature(s)*Place and Date

    * First and last name(s) in block letters:

    M

    ER CH

    aN t Company

    Company address Street + No.

    Postal code / City Country

    Merchant No.

    Function

    E-mail

    Phone

    Fax

    Contact person  Mr.  Ms. First name Last name

    P.O. Box No.

    SIX Payment Services (Europe) S.A. 10, rue Gabriel Lippmann, L-5365 Munsbach

    Mailing address: SIX Payment Services, Hardturmstrasse 201, P.O. Box, CH-8021 Zurich For your local contact: www.six-payment-services.com/contact

    SIX Payment Services Ltd Hardturmstrasse 201, CH-8021 Zurich

    Please submit the duly completed and signed form by fax, e-mail or post.

    For Switzerland: For the rest of Europe: Fax: 0848 83 2000 Fax: +352 20 880 228 customerservice.ch@six-payment-services.com info.cwe@six-payment-services.com SIX Payment Services, Customer Service Switzerland SIX Payment Services, Merchant Service International Hardturmstrasse 21, P.O. Box, CH-8021 Zurich Hardturmstrasse 21, P.O. Box, CH-8021 Zurich

    Vertragspartner-Nr: Postfachnummer: PLZ: Ort: Land: K-Anrede: Off K-Vorname: K-Name: K-Funktion: K-Telefon: K-Email: K-Fax: Nullpunkt: gueltigper: PSPold: AccountIdold: Tagold: Monatold: Jahrold: PSPnew: AccountIdnew: Jahrnew: Monatnew: Tagnew: Firma1: Strasse: Druckbuchstaben: OrtundDatum:

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