Create Provider

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myBills LiveEnvironment Merchant Account Request Form

Create Provider

Merchant account is already configured in GPG and will continue to be used in parallel with myBills HPP /

Amend Provider

Request Date: / Request Time:
Processed Date: / Processed Time:
Provider Name / English
Maltese
Provider Profile / English
Maltese
Site URL / English
Maltese
Functionality / Electronic Bill Presentment and Payment / HPP
Accounts / ON / OFF
Provider Controlled Recurring Payments / ON
OFF / OFF
Payment on account / ON
OFF / OFF
Status / ON / ON
Accept Payments across this Provider Accounts / ON
OFF / OFF
Payments / ON / ON
Allow payments for multiple invoices / ON
OFF / OFF
Automatic Subscriptions upon user first login / ON
OFF / OFF
Foreign Link to Provider on journal Entries / ON
OFF / OFF
Display Email in Payment Screen / ON
OFF
Custom skin for payment page / OFF / OFF
ON
New Skin (CSS)
Use same Skin from Test Environment ______
Web Service Url
url of where the Notifications webservice will be hosted
Web Service Username
Authentication to access Notifications webservice
Web Service Password
Authentication to access Notifications webservice
Electronic Bill Presentment and Payment / HPP
Custom Field (if any) / Number / 1
Validation pattern / Not Applicable
English Name / Not Applicable
English Short Description / Not Applicable
English Long Description / Not Applicable
Maltese Name / Not Applicable
Maltese Short Description / Not Applicable
Maltese Long Description / Not Applicable
Not Applicable
Number / 2
Validation pattern / Not Applicable
English Name / Not Applicable
English Short Description / Not Applicable
English Long Description / Not Applicable
Maltese Name / Not Applicable
Maltese Short Description / Not Applicable
Maltese Long Description / Not Applicable
Not Applicable
Number / 3
Validation pattern / Not Applicable
English Name / Not Applicable
English Short Description / Not Applicable
English Long Description / Not Applicable
Maltese Name / Not Applicable
Maltese Short Description / Not Applicable
Maltese Long Description / Not Applicable
Not Applicable
Number / 4
Validation pattern / Not Applicable
English Name / Not Applicable
English Short Description / Not Applicable
English Long Description / Not Applicable
Maltese Name / Not Applicable
Maltese Short Description / Not Applicable
Maltese Long Description / Not Applicable
Not Applicable
Number / 5
Validation pattern / Not Applicable
English Name / Not Applicable
English Short Description / Not Applicable
English Long Description / Not Applicable
Maltese Name / Not Applicable
Maltese Short Description / Not Applicable
Maltese Long Description / Not Applicable
Supplementary Provider Information
Electronic Bill Presentment and Payment / HPP
Corporate Information (English and Maltese Versions) / (Required)
Soft Copy Provided / NotApplicable
Contact Details (English and Maltese Versions) / (Required)
Soft Copy Provided / Not Applicable
Terms and Conditions (English and Maltese Versions) / (Required)
Soft Copy Provided / (Required)
Soft Copy Provided
Provider Logo (English and Maltese Versions) / (Required)
Soft Copy Provided / (Required)
Soft Copy Provided

Provider Account Details

Please tick the Institution/s being used and list the Account Number and Terminal ID for each institution.
Bank Institution / Account Number / Terminal ID
BOV HSBC
BOV HSBC
BOV HSBC
BOV HSBC
BOV HSBC
BOV HSBC

CARD DETAILS

Please tick the Card Types accepted by this Client and fill in relevant information, where applicable.
CARD / ADDITIONAL INFORMATION
VISA
MASTERCARD
CASHLINK
QUICKCASH
APS PREMIERE

Contact Details

Government Department/Entity
Surname: / Phone Number (Fixed):
Name: / Phone Number (Mobile):
e-mail address:
Supplier
Surname: / Phone Number (Fixed):
Name: / Phone Number (Mobile):
e-mail address:

myBills Configuration Details (Office Use Only)

Business Group: / Transactium Client ID:
Business Unit: / Transactium Cashpoint ID:
MITA Merchant: / MITA Merchant ID:

myBills Test Environment Merchant Account Request FormPage 1 of 5