1. Below is a form to register your business for EDOMx Core Products: Faraja, Fanaka, MMF and Other.

2. To register for Cashback visit: www.faraja-cashback.co.ke or Click Here

Merchant Application: Core Products

Section 1: Merchant Details

Registered Name

Company Trading Name

Physical Address

VAT

Business Email

Business Phone

Section 2: M-PESA Business Details

Paybill Number

Account Number (Paybill)

Till / Buy Goods Number

Store / H.O / Number

M-PESA Nominated Number

Section 3: Contacts

Business / Billing Contact

Full Name

ID Number

Phone

Full Name

ID Number

Phone

Section 4: Discount Structure

Yes, subscribe me to your 5% discount rate.

Company Registration

Upload PDF: Max 2MB

KRA PIN Certificate

ID or PASSPORT

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Please sign or upload the authorized signature.

Section 5: Declarations

By submitting this form, you agree to the EDOMx Merchant Agreement and Terms & Conditions.