Agent Form – Monty Global Payments

Agents

Commercial name of the call shop / store*

Name of the agent contract holder*

ID/CIF of the holder*

Holder's country of origin*

Full address of the premises where the activity is carried out*

Postal code*

Phone number(s)*

Town/City*

Province*

How many years have you been carrying out the money transfer activity in this premises*

How many years has the current owner been in charge?*

Do you have employees?*

Yes No

What other activities are carried out in the premises, in addition to money transfers*

Main countries to which you send*

How did you hear about Monty*

Why are you interested in Monty's money transfer service*

Do you work with any other payment entity?*

Yes No

1.1 - Name of the entity

1.2 - Number of transfers/month with that entity

2.1 - Name of the entity

2.2 - Number of transfers/month with that entity

3.1 - Name of the entity

3.2 - Number of transfers/month with that entity

4.1 - Name of the entity

4.2 - Number of transfers/month with that entity

5.1 - Name of the entity

5.2 - Number of transfers/month with that entity