Request for Google Pay Issuer Click-to-Accept Agreement Thank you for your interest in Google Pay! Please fill out the information below. * Required fieldPlease tell us who you are *If you are unsure, please select New issuer in a live Google Pay countryNew Issuer in live Google Pay countryNew Issuer not based in a live Google Pay country BIN Sponsor or program manager notifying Google of a sub-entity launchThank you for your interest in Google Pay! Please fill out the information below. Submitting this form is only a request to receive the Click-to-Accept agreement and not acceptance of the actual agreement terms. We will send you a Non Disclosure Agreement (NDA), followed by the agreement itself upon acceptance of the NDA to the email address you provide.Google Pay is NOT live in your country and therefore submitting this request is only to receive access to our documentation. Once you have accurately completed and submitted the form below, we will send you a Non Disclosure Agreement (NDA) which you will be required to e-sign and return to us. Upon completion of the NDA, we will grant access to the Google Pay Developers Site for the emails requested below. Please note that any future Google Pay expansion information is covered under the NDA and cannot be shared with outside parties other than as set out in the NDA, unless explicitly approved by GooglePlease complete this section if you are a BIN Sponsor or Program manager adding a program and/or issuer under your BIN sponsorship.Legal Name of Issuing Entity *This is the legal name of your organization, i.e. how you would be listed on a tax return, not your Doing Business As (DBA) name. Please provide the name in latin characters,if applicable.Legal Name of Issuing Entity in Local Language, if applicable (i.e. Kanji for Japan)Must be included if the issuing entity name in the local language is different than the Legal Name of issuing entity.Physical Legal Mailing Address of Issuing Entity *Country of Issuing Entity *Select oneAlbanienArgentinienArmenienAustralienÖsterreichAserbaidschanBahrainWeißrusslandBelgienBermudaBosnia & HerzegovinaBrasilienBulgarienKambodschaKanadaChileKolumbienCosta RicaKroatienZypernCzechiaDänemarkDominikanische RepublikEcuadorEl SalvadorEstlandFinnlandFrankreichGeorgienDeutschlandGriechenlandGrönlandGuernseyHongkongUngarnIslandIndienIrlandIsraelItalienJapanKasachstanKosovoKuwaitKirgisistanLettlandLiechtensteinLitauenLuxemburgMacauMazedonienMalaysiaMaltaMexikoMoldawienMonacoMontenegroMarokkoNiederlandeNeuseelandNicaraguaNorwegenPanamaParaguayPeruPolenPortugalKatarRumänienRusslandSan MarinoSerbienSingapurSlowakeiSlowenienSüdafrikaSpanienSchwedenSchweizTaiwanTadschikistanThailandUkraineVereinigte Arabische EmirateVereinigtes KönigreichUnited Kingdom TerritoryVereinigte Staaten United States TerritoryVietnamOtherCountry where the Issuing Entity wants to launch Google PayIf 'Other' is selected, please provide the CountryIssuing Entity's WebsiteFirst and Last Name of Signatory *Title of Signatory *Email Address of Signatory *A corporate email address is required. Personal email addresses are not acceptable for Google contracts.Legal Name of BIN Sponsor *Country of BIN Sponsor *Email Address(es) for Issuer Documentation Access (separate by comma):*IMPORTANT: Email addresses listed here must be associated with a Google account. Developer site access cannot be provisioned until the Google Account association process has been completed.Please enter a valid email address.Please check appropriate card portfolio(s) *Consumer DebitConsumer CreditBusiness DebitBusiness CreditPrepaidUnsureOtherPlease explain *Processor *Please check appropriate network(s) *Check all that applyAmerican ExpressDiscoverMastercardVisaInteracOtherBID *?This is the Business ID number given to you from Visa. If Visa is unable to provide this value you can enter "unknown", however it may result in delays processing your request.Please enter only 8 charactersCID *?This is the issuer ID number given to you from Mastercard. If Mastercard is unable to provide this value you can enter "unknown", however it may result in delays processing your request.Please enter only 8 charactersOther network name *Target Launch DateIf you would like to provide generic company email group(s) to receive notifications regarding Google Pay CTA agreement updates, add them below:Add additional fieldProvide any additional details that will help expedite your request:If you are an issuer transitioning from a bilateral to a CTA, please check this box to help us quickly identify you.Provide any additional details that will help expedite your request:SendenSubmittedEdit requestDownload submission https://myaccount.google.com/privacypolicy?hl=$0 Some account and system information will be sent to Google, and support calls and chats may be recorded. We will use this information to improve support quality and training, to help address technical issues, and to improve our products and services, subject to our Privacy Policy and Terms of Service. Translation services may be used in chats and email. Additional info OK Your email has been sentThanks for your interest in Google Pay. We'll follow up with you as soon as possible on next steps.Edit requestDownload submission