IRF - Partner

Modulr Partner Application Form
This application form helps us understand your business and your customers. Providing the most up-to-date and accurate information aids a smoother onboarding, ensures all regulatory obligations are met, and most importantly protects your business & your customers.

Please confirm your answers are detailed and provide any information you believe to be relevant, even if not explicitly requested.

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Please select the country in which your business is registered in*

Account Signatories

These are the individuals elected by the Business to have access and permission to make and authorise payments, view account information and control access. The account Signatories will be responsible for the management of the Account, also known as an "Authorised User". You can have 1 or multiple.
Account Signatories*

Relationship Manager

This is the individual elected by the Business to be responsible for the management of the relationship with Modulr.
Full Name*
Email Address*
Contact Number*

Beneficial Owners

As a regulated entity, we must validate who controls the business (Persons with Significant Control – “PSC”) and the people that ultimately stand to benefit economically from the business (Ultimate Beneficial Owners – “UBO”). If the business has a complex ownership structure, we will need to understand the rationale for this. The objective of performing these checks is to ensure a business is not being used for money laundering, criminal terrorist financing or other illegal activities.
- Please provide details of ALL the Beneficial Owners of the business. Beneficial Owners are individuals who own 25% or more of the business.
- Note: Where the business is owned by another business (a parent company), the Beneficial Owner may be a shareholder of that parent company. Please include these individuals if, as a result of the ownership, they would own 25% or more of the applying business.
- If nobody owns at least 25% of the business, please add the majority owner(s) of the business as the Beneficial Owners.
- We must receive accurate and genuine information, otherwise, the application may fail.
Ultimate Beneficial Owners/Persons of Significant Control *
Please provide a summary of the structure and any relevant rationale to support our understanding. This should include a commercial rationale.
If you have 2 or more layers of ownership, please provide an authorised shareholding structure

Share Register/Annual Return for all entities in the ownership chain; or ownership structure chart showing % ownership certified by the counterparty’s external financial auditor
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Directors

Please provide the below information for all Company Directors
Directors *

Nature of Business

Modulr, as a regulated entity, must understand the business with whom it is contracting. To achieve this, please provide detailed responses to avoid clarification requests.
What does your business do? Please provide a detailed explanation of the products and/or services your company offers. *
What is your plan to market growth in the next 3 years?*
E.g., jurisdiction, products, sectors, etc.
Please provide your website URL

Customers

Understanding your customers and how they interact with your business allows us to know more about your approach to the market and consider any risks that this may bring
Please describe your typical customers (are they consumers, corporate or both).*
In what countries are your customer based?*

How many customers do you have/expect to have?*

	Today	Next Year	Two Years	Three Years
UK
Europe

Do you have any live customers already?*

YesNo

Payments through Modulr

This will help us understand who will be funding Modulr accounts, how they will be used, and where funds will be sent. This information will assist Modulr in identifying any associated risks and will have implications from a regulatory perspective & a technical setup.

Your Modulr Account	This refers to your Modulr account. This relates to funds owned directly by your business and payments made directly to or from your business.
Your Customers Modulr Account	This refers to the accounts of your customers, you will introduce to your platform and Modulr refers to this group as “introduced customers”. All funds in these accounts are the possession of your customers, the Payment Service Users.

Your Modulr Account
What is the anticipated use of your Modulr Account (i.e., collection of fees, disbursements, etc.) *
Do you have/expect to have any peak transaction volume/value days throughout the month?*

YesNo
Please advise what type of transactions:

InboundOutboundBoth

What is the total anticipated balance of funds held in your Modulr Account?*

	GBP	EUR
Average Balance
Maxiumum Balance

Who will you pay from your Modulr account and why? *
E.g., suppliers, employee payroll etc.
Which countries will payments be sent?*
From which countries will payments be received?*
Who will be making payments to your Modulr account?*
E.g., customers, inter-company transfer etc.

Please provide details of the Bank account(s) you will be used to fund your Modulr account (i.e your bank account, liquidity provider and foreign exchange operators). *

	Institution Name	Jurisdiction
1
2
3

What is the anticipated maximum single/daily value of payments into/out of your Modulr Accounts?*

	GBP	EUR
Daily In to your account
Daily Out of your account
Single maximum in to your account
Single maximum out of your account

Your customers’ Modulr Account usage
What is the anticipated use of your customers’ Modulr Account (i.e supply chain purchases, etc.) *
Who will your customers pay from their Modulr accounts and why (please include the industry/business sector of these beneficiaries)?*
Who will your customer be receiving payments from to the accounts (please include the industry/business sector)?*
Which countries will payments be sent?*
From which countries are payments anticipated to be received?*
How will your customer fund their Modulr accounts?*
E.g., payments from customers, intra-company transfers etc.

What is the anticipated maximum daily value of payments into/out of your customer's Modulr accounts?*

	GBP	EUR
In to the account
Out of the account

Payments out of the Modulr account

Modulr will apply account controls to oversee and manage the Modulr platform and your Modulr accounts. For this, we need you to share your expected maximum daily value and volume from the different types of accounts you might have in our portal.

Maximum daily Expected Outbound Activity*

	GBP	EUR	Volume
All Payment from your Modulr Accounts
Payments from a single (introduced customer) Modulr Account
All outbound payment activity from your and introduced customers’ accounts combined

Compliance Information
PSD2 Requirements

To make online payments more secure and reduce fraud, SCA requires all Payment Services providers to undertake SCA.

SCA is intended to enhance the security of payments and limit fraud. It aims to ensure the person requesting access to an account, or trying to make a payment has been duly authenticated.

Please complete the below and provide evidence where applicable.
Strong Customer Authentication (SCA) – as per the Payment Service Regulations 2017: ‘authentication based on the use of two or more elements that are independent, in that the breach of one element does not compromise the reliability of any other element, and designed in such a way as to protect the confidentiality of the authentication data, with the elements falling into two or more of the following categories:
1. something known only by the payment service user (“knowledge”);
2. something held only by the payment service user (“possession”);
3. something inherent to the payment service user (“inherence”);’
For more information, click here
Is the product/service you are offering in scope for SCA requirements?*

YesNo
Please detail why you are not in scope and if you are utilising regulatory exclusions:
Please detail how you will implement SCA Compliance:
What factor will you be using?

KnowledgePossessionInherence
Describe how you will adhere to 'Dynamic Linking' requirements:
Please provide diagrams/evidence to support your answers

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If working towards regulatory compliance, please set the target date for achieving:

DayMonthYear
Date

Compliance Information
Account Servicing Payment Services Providers (ASPSP)

As per the Payment Services Regulations (PSR) 2017: ‘“account servicing payment service provider” means a payment service provider providing and maintaining a payment account for a payer’. The PSRs 2017 stipulate that ASPSPs must provide Third Party Providers with access to account data and payment functionality. As the Third-Party Provider will be requesting this information from Modulr’s partner and not Modulr directly, we need to understand the chosen method and how applicable Partners comply with the regulations.

For more information, click here.
Is the product/service you are offering in the scope of ASPSP requirements relating to account information and payment initiation?*

YesNo
Please detail why you are not in scope and if you are utilising regulatory exclusions:
Please confirm which of the following solutions you will have in place to facilitate an authorised Third Party Provider (TPP) with access to account information (AIS) and payment initiations (PIS) services in line with Article 31 of the SCA-RTS:
Have you built or are you intending to build a Dedicated Interface?
An interface other than the payment service user interface (PSU) or a modified customer interface (MCI) as defined in the EBA Regulatory Technical Standards on Strong Customer Authentication and Common and Secure Communication (SCA-RTS) Article 32(4)
Please provide diagrams/evidence to support your answers

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If working towards regulatory compliance, please set the target date for achieving:

DayMonthYear
Date

Direct Debit
Will your customers collect payments via Direct Debit?*

YesNo
Do you currently collect Direct Debits?*

YesNo
How many SUNs (Service User Numbers) do you have, and who is your sponsoring Bank?*
How many rejections do you receive every month?
What is the average (or expected) number of DD sign-ups per month?*
What is the average (or expected average) value of Direct Debit payments?*

Physical Cards
Have you assigned limits to your card programme?*

YesNo

Have you assigned ATM limits to your card programme?*

YesNo

Do you block any merchant category codes?*

YesNo
Please select all MCCs blocked
Please select any MCCs you require Modulr to block
Please share the customer guide for reporting a card stolen or lost. This should include blocks added to the card and reissue procedures.

Cancelof
How many times can a PIN be inputted incorrectly before the card is blocked?

	Per Day	Per Month	Per Year
Limit

	Per Day	Per Month	Per Year
Limit

Industries

Please select from the options below if your business is engaged in one of these industries
Please confirm if you operate in either of the below industries*

CryptocurrencyEmployment ServicesNone of the above

Industry - Cryptocurrency
Do you have the required cryptocurrency registration for the jurisdiction you are operating (where you physically are)?*

YesNo
Please provide details of the firm’s regulatory cryptocurrency registration.
Please list all jurisdictions in which the business or group has offices or operations*
If you believe you do not need to register, please provide an opinion or rationale to support this position
*Please note that we may require a legal opinion to support this position.
Upload your legal opinion on crypto registration

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Please provide a summary of your senior management team experience within the cryptocurrency sector *
Please upload the CVs of your senior compliance staff*

Cancelof
Please provide an overview of the firm’s transaction monitoring framework including the tools (i.e. Chainalysis, Elliptic, etc.) used and the procedures in place to conduct transaction monitoring *
Transaction Monitoring Framework, procedures etc.
Cancelof
If you do not have a transaction monitoring framework and tools in place, please detail what will be implemented and by when:
Does the firm facilitate privacy coin activity?

YesNo
Please provide a list of all cryptocurrencies your platform with be utilising. If you will use a coin but it is not listed, please advise.

Declaration

I hereby declare and confirm that the information provided here is accurate, correct and complete and that the documents submitted along with this application form are correct
Signature*

Clear
Date

DayMonthYear
Date
Thank you for submitting your Customer Request Form

Thank you for choosing Modulr. If we have any question, we'll contact you via email.
Should be Empty:

	Low Risk	Standard Risk	High Risk
Number
Percentage

Modulr Partner Application Form

Company Details

Account Signatories

Relationship Manager

Beneficial Owners

Directors

Nature of Business

Customers

Payments through Modulr

Your Modulr Account

Your customers’ Modulr Account usage

Payments out of the Modulr account

Compliance Information

Compliance Information

Products

Direct Debit

Physical Cards

Virtual Cards

Industries

Industry - Cryptocurrency

Industry - Employment services

Declaration

Thank you for submitting your Customer Request Form