Request for Google Pay Issuer Click-to-Accept Agreement

Please tell us who you are *

If you are unsure, please select New issuer in a live Google Pay country

Thank 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 Google

Please 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 *

Country where the Issuing Entity wants to launch Google Pay

If 'Other' is selected, please provide the Country

Issuing Entity's Website

First 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) *

Please explain *

Processor *

Please check appropriate network(s) *

Check all that apply

BID *

Please enter only 8 characters

CID *

Please enter only 8 characters

Other network name *

Target Launch Date

If you would like to provide generic company email group(s) to receive notifications regarding Google Pay CTA agreement updates, add them below: Add additional field

Provide 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:

Request for Google Pay Issuer Click-to-Accept Agreement

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