Please select your country
Please Type the State of your residential address
Who is the request for?
Please provide their full name and your relationship to the third party. You must also attach proof of authorization (can be done at he bottom of the form)
Please provide your address as listed on your account
I certify under penalty of perjury that I am a California resident, that all information I have submitted is true and accurate, and that I am the individual, or authorized agent of the individual, whose information is the subject of this request.”
We collect and handle personal data in accordance with our Privacy Policy (https://www.afterpay.com/privacy-policy). We'll use personal data submitted through this form to manage your account or respond to your query. If you agree, check box to continue.
If you are a merchant - Please provide the Merchant ID - this can be found online within your Online Account. If you are a new merchant type NA.