Sign Up – Vendors – Edenred

Your Customers

Customer(s) payments to be received from*

How did you hear about this payment method change?

Direct Mail Letter
Email
Welcome Letter
Phone Call
Other

If other please tell us how.*

Your Company Information

* Required

Company Name*

Company Legal Name (If different)

Industry*

Main Phone Number*

Fax*

Physical Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is company's billing address the same as the physical address?*

Yes
No

Billing Address (If different than physical address)*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Tax ID Number or Business Number (BN)*

Website (If applicable)

Remittance Email Address: Where we will send payments*

Enter Email Confirm Email

Primary Contact

Accounts Receivable Contact Name*

First Last

Accounts Receivable Contact Title*

Phone*

Extention

Alternate Email Address (If different than remittance email address)

Enter Email Confirm Email

Enrollment Information

Can your company process payments in USD / US Dollar or CAD / Canadian Dollar?*

Please attach a copy of your W-9 for our records.

Downloadable W-9 Form here

This enrollment assumes your company has the ability to process credit card payments without additional fees, change in terms and/or loss of discounts unless specifically outlined here.

By checking this box, you confirm that your company has the ability to process credit card payments without additional fees, changes in terms or pricing, or loss of discounts.*

As a preferred vendor you agree to accept credit card payments from any of our customers in keeping with the same terms as listed above including the ability to process credit card payments without additional fees or terms unless specifically outlined here. *Increase the number of customers that will use your services. You will accept credit card payments for all Edenred Pay customers with the same terms selected in place. Once listed as a Edenred Pay preferred vendor all of Edenred Pay customers (10,000 +) will see you listed on our preferred vendor site.

Yes
No

Would you like to be setup as an auto-enrolled vendor for future Edenred Pay customers?*

This option is only available for vendors that do not charge fees or have any changes in terms for credit card payments, including loss of discount

Yes
No

Vendor Enrollment Form

To enroll as an Edenred Pay vendor please complete the form below

Your Customers

Your Company Information

Primary Contact

Enrollment Information