RAQEEM

Iraq Payment Network

Confidential

Card Program — BINs Application Form

Central Bank of Iraq — National Payment System

Instructions:: Please complete all sections. All information must be typed or printed. Fields marked with (*) are mandatory. If applying for more than one program/cards type, submit a separate application for each program.

Applicant Information

Full Name*

Title / Position*

Email Address*

Phone Number (+964)*

Department