CVFR Application - www.mintpayments.com

Choose your product
Product Options*
Tell us about yourself
Director/Owner Name*
First Last
This application can only be completed by the owner or director that has 50% or more share of the business/company. This directors details must be continued in the form below.
Phone Number (Landline)*
Director/Owner Phone Number (Mobile)*
Director/Owner Email*
By clicking next, you agree to be contacted by one of our friendly staff members.

Save and Continue Later

We require one form of ID from the Director above. Please select your ID format that you can present.*
Director/Owners Drivers Licence Number*
Passport Number*
Proof of ID Photo Card Number*
Director/Owner Date of Birth*
DD slash MM slash YYYY
Director/Owner Home address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Australia
Have you ever declared bankruptcy?*
- No
- Yes
Bankruptcy discharge date*
MM slash DD slash YYYY

Save and Continue Later

Settlement account details

This is the account where payments you receive will be deposited into.
Account name (Settlement)*

Note that this is the name of the account, not the name of the bank or account type.
BSB (Settlement)*
Account number (Settlement)*
Deductions account details

The account from which your fees will be deducted
Same As Above*
- Same as above
Account name (Debit)*

Note that this is the name of the account, not the name of the bank or account type.
BSB (Debit)*
Account number (Debit)*
Supporting Documents
Driver's License or Photo ID Card (Copy or Photo)
Drop files here or

Max. file size: 10 MB.
Only colour copy back and front will be accepted.
Proof of ID Card (Copy or Photo)
Drop files here or

Max. file size: 10 MB.
Only colour copy back and front will be accepted.
Passport (Copy or Photo)
Drop files here or

Max. file size: 10 MB.
Only colour copy will be accepted.
Bank Statement (Copy, PDF or Photo)
Max. file size: 10 MB.
Utility Bill (Copy, PDF or Photo)
Max. file size: 10 MB.
Terms & Conditions
Links to all agreements, terms and conditions (our own, partners and acquirers) are located in our website footer on our home page here: www.mintpayments.com
Please read and accept the following.*
- I have read, understood and agree to be bound by the Mint Sales Australia Pty Ltd (Mint) Terms and Conditions. I agree that those shall be the only terms of any contract entered into with Mint. I confirm that all the information contained in this application is true and correct and that any information subsequently provided in support of this application will be true and correct.
- I have read, understood and agree to be bound by Mint Payments Acquirer & Partner Agreements and Terms & Conditions. I confirm that I have read and understood the relevant terms available online (see link here).
- I hereby request and authorise Mint Australia Pty Ltd (Debit User No. 513441 & 252550) to debit my / our nominated bank account provided above through the Bulk Electronic Clearing System for any amount that Mint (Aust) Pty Limited may debit or charge in accordance with the terms and conditions set out in the Service Agreement. I acknowledge that this DDR is governed by the terms of the Service Agreement and is to remain in full force in accordance with the terms and conditions contained in that Service Agreement.
- Please keep me updated with news and offers.
(see link here)
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Save and Continue Later

Step 1 of 4

Choose your product

Tell us about yourself

Tell us about your business

Settlement account details

Deductions account details

Supporting Documents

Terms & Conditions