• 1
    Company
  • 2
    Personal details
  • 3
    Products
  • 4
    Billing
  • 5
    Signature
* Unless stated otherwise, all fields on this form are mandatory.
Your Payconiq partner:
PQ Belgie
Add a .pdf document (max. 5MB)
Registered office as in CBE
Contact person
?
This person is the primary contact person for Payconiq within your organization. This person will also receive admin rights when accessing the Merchant Portal.