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Merchant Off-boarding Request form

Brand Name

*

Business ID (Atlas Portal > Profile (Top-right) > Copy Business ID)

*

Email ID

*

Region

*

POS Name

*

Disintegration request type

*

No. of outlets to be disintegrated

*

Names of locations (separate using comma for multiple outlets)

*

Aggregators to off-board / disintegrate

*

Reason for disintegration / off-boarding

*

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