Blackhawk Network Mexico Corporate Client Application

Blackhawk Network Mexico Corporate Client Application

Aplicación de cliente corporativo Blackhawk Network

This Blackhawk Network form is securely provided by our approved third party vendor Smartsheet Inc.. To review Smartsheet Inc.'s Security Statement, please go to: https://www.smartsheet.com/security.

Este formulario de Blackhawk Network se proporciona de forma segura por nuestro proveedor externo, Smartsheet Inc. Para revisar la Declaración de Seguridad de Smartsheet Inc., visite: https://www.smartsheet.com/security.

Business Client Information / Información del Cliente

Business Tax ID Number / RFC*

Legal Business Name / Razón Social*

DBA (doing business as) / Nombre Comercial

Business Address Line 1 / Dirección Fiscal Línea 1*

Business Address Line 2 / Dirección Fiscal Línea 2

City / Ciudad*

State / Province / Estado*

Zip Code / Postal Code / Código Postal*

Country / País*

Legal Representative's Information / Información del Representante Legal

Legal Representative's Name / Nombre del Representante Legal*

Phone Number of Legal Representative / Teléfono de contacto del Representante Legal*

Email Address of Legal Representative / Mail del Representante Legal*

Tax ID # (CURP) of Legal Representative / CURP del Representante Legal*

RFC of Legal Representative / RFC del Representante Legal*

Core Business Activity / Giro de la Empresa*

Business Website / Página Web de la Empresa*

Date of Incorporation / Fecha de Constitución de la Empresa*

Place of Incorporation (Nationality) / Lugar de Constitución de la Empresa*

Type of Client / Tipo de Cliente

What type of BHN client is your business?*

A Direct Corporate Client funds and utilizes the prepaid products directly.

An Authorized Partner (Reseller) orders on behalf of another corporate client that originates the funding and utilizes the prepaid products.

¿Qué tipo de cliente eres para BlackHawk Network?

Cliente Corporativo Directo; paga y utiliza los productos prepagados directamente.

Tipo de Cliente

Socio Autorizado (Re-vendedor) ordena en nombre de otro cliente corporativo que origina el pago y utiliza los productos prepagados.

Select

If Authorized Partner was selected above, do you agree to have business policies and practices to support the Operations Manual supplied to you by BHN?*

For BHN Authorized Partner Operations Manuals go to: https://connect.blackhawknetwork.com/publically-accessible-reference-documents/hawk-incentives-partner-information-manual-mexico

Si seleccionó Socio Autorizado anteriormente, ¿acepta que las políticas y prácticas comerciales respalden el Manual de Operaciones que le proporciona BHN?

Para obtener los Manuales de Operaciones de Socios Autorizados de BHN, vaya a: https://connect.blackhawknetwork.com/publically-accessible-reference-documents/hawk-incentives-partner-information-manual-mexico-spanish

Select

Are you a Low-Volume Client? / ¿Es usted un cliente de bajo volumen?*

Clients that order no more than MXN $5,835.63 per month are considered “Low-Volume” Clients.

Los clientes que ordenan no más de MXN $5,835.63 por mes se consideran clientes de “bajo volumen”

By selecting the “Low-Volume” order type, you agree that any orders exceeding the “Low-Volume” threshold require that the Beneficial Owner Form with required Identifying Information be submitted to Blackhawk Network and approved prior to the order being processed. Please go to https://connect.blackhawknetwork.com/ArticleDocuments/307/Beneficial%20Owner%20Blackhawk%20Network.doc.aspx for a copy of the Beneficial Owner Form.

Al seleccionar el tipo de pedido de "Volumen bajo", usted acepta que cualquier pedido que exceda el umbral de "Volumen bajo" requiere que el Formulario de beneficiario con la Información de identificación requerida se envíe a Blackhawk Network y se apruebe antes de que se procese el pedido. Ingrese a https://connect.blackhawknetwork.com/ArticleDocuments/307/Beneficial%20Owner%20Blackhawk%20Network.doc.aspx para obtener una copia del formulario del propietario beneficiario.

Select

Type of Products / Tipo de Productos

What type of products will your business be ordering? / ¿Qué tipo de productos desea para su negocio?*

Select

Description of how Prepaid Products will be used / Describe cómo se utilizarán los productos prepagados*

Select

If "Other", describe how Prepaid Products will be used / Si es "Otro", describa cómo se utilizarán los productos prepagados

Passwork for BULK Activation (optional) / Contraseña para la activación en volumen (opcional)

Information on the ID Collected from Legal Representative / Información sobre del ID del Representante Legal en los siguientes 3 campos

Next 3 Fields

Issuance Authority / Institución que emite el documento*

Name of Document / Nombre del documento*

Official Number / Número oficial*

Documentation Required to be Uploaded Below:

o A copy of the incorporation deed of the company duly registered before the Public Registry of Commerce

o Government issued documentation on RFC for the business o Government issued documentation on CURP for the Legal Representative

o Government issued documentation on RFC for the Legal Representative

o Proof of Residence - (business invoice dated within the past three months), “Comprobante de domicilio” – A utility invoice with current business address and your business RFC # printed on invoice is best

o A copy of Legal Representative's ID provided

o A copy of the Power of Attorney granted to the Legal Representative

o An executed Beneficial Owner Form with required Identifying Information, as noted in form. Please go to https://connect.blackhawknetwork.com/ArticleDocuments/307/Beneficial%20Owner%20Blackhawk%20Network.doc.aspx for a copy of the Beneficial Owner Form.

Documentación requerida:

o Copia del Acta Constitutiva de la compañía debidamente registrada ante el Registro Público de Comercio.

o RFC de la empresa. CURP del Representante Legal.

o Comprobante de domicilio en donde se muestre la dirección actual de la empresa y el RFC (No mayor a tres meses de antigüedad).

o ID del Representante Legal.

o Copia del Poder Notarial en donde se muestre el nombre completo del Representante Legal.

o Formato del Propietario Beneficiario requisitado y firmado por el Representante Legal, para descargar este formato ingrese al siguiente link https://connect.blackhawknetwork.com/ArticleDocuments/307/Beneficial%20Owner%20Blackhawk%20Network.doc.aspx

Upload all required documentation prior to clicking submit / Suba toda la documentación requerida antes de hacer clic en enviar:

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