e-Path Gateway Application

Thank you for your interest in applying for an e-Path payment gateway.

Please complete the detals below and an e-Path representative will be in contact with you.


Apply for an e-Path payment gateway:


1. Select Gateway Type:
 About The Services
Payment Gateway - Single Licence Single Licence
$275.00 AU$ incl GST - Yearly Fee
$22.00 AU$ incl GST one time - Registration
TOTAL: $297.00 AU$ incl GST
Payment Gateway - Multiple Licence Multiple Licence
$341.00 AU$ incl GST - Yearly Fee
$22.00 AU$ incl GST one time - Registration
TOTAL: $363.00 AU$ incl GST

2. Gateway Usage:
 About The Services
Your Website URL:
Other URL's (if applicable):
e-Path Payment Alert Emails To:
.
NOTE: This email address becomes part of the encryption system. It can not be changed without an extra cost involved.

3. Your Details:
 Your Details
Your Name:
Your Email Address:
Land Based Phone Line:
Land Based Phone Line Address:
Mobile (if applicable):

4. Your Business Details:
 Business Details
Business Name:
ABN (if applicable):
Land Phone:
Fax (iffapplicable):
Mobile (if applicable)
Street Address:
Suburb/Town/Province:
Postcode/Zip:
     State:
Country:

5. Your Merchant Account:
 Your Merchant Account
Do you have a merchant account facility approved to allow you to charge into it card-not-present credit card payments received?
 YES
Merchant Account Name, i.e., your business name that appears on your customers credit card statements.
Credit Cards Accepted:
(Credit cards types your merchant account can process)
 Visa
 American Express
 Discover
  Mastercard
 Diners Club
 JCB
Other Credit Cards Accepted:

6. Legal Requirements:
 Legal Requirements
Do you understand
e-Path's Requirements?
 YES   e-Path Requirements
Do you understand and agree to the e-Path TOS & MA?
 YES   Terms Of Service/Merchant Agreement
Do you agree to the e-Path Gateway Refund Policy?
 YES   e-Path Refund Policy

7. Send Application Now:
 Sending Your Application
Click To Send & Make Payment:


Please Note:
1. The submitting of this form and authorising payment for service does not constitute the application approval. All applications are pending approval of e-Path Pty Ltd.
2. Your credit card will be charged upon application approval only.
3. In some circumstances it may be necessary for e-Path to request further information to facilitate the processing of applications.
The e-Path Credit Card Payment Gateway
 Home
The Credit Card Payment Gateway
How e-Path Works
Merchant Requirements
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About e-Path Pty Ltd
Strategic Partners & Providers
e-Path Security
 CDU Security Compliance
Payment Gateway Integration
About the PCI DSS
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 e-Path Blog Payment Gateway Blog
TOS, UA, Merchant Agreement
Privacy Policy
Contact e-Path
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Site Content Disclaimer
Reduce your e-commerce costs with e-Path e-Path exclusively uses THAWTE SSL
This website makes no determination as to the suitability of the e-Path service for your particular personal or business needs.
e-Path is an Australian based global provider of the e-Path Internet Credit Card Payment Gateway Service.
All Rights Reserved - Copyright 2006 - E-PATH PTY LTD
ACN:124032917 | ABN:70124032917
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