Create Provider

/
myBills Test Environment Merchant Account Request Form

Create Provider

/

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 / ON
OFF
Web Service Details below are not to be provided for services running on the eForms and eProcurement platforms.
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

Contact Details

Surname: / Phone Number (Fixed):
Name: / Phone Number (Mobile):
e-mail address:

myBills Test Environment Merchant Account Request FormPage 1 of 2