It is recommended that the filename contains the technical or commercial FESE name specified in the registration form along with the version. The number 1 at the end of the filename indicates first registration form submitted for this FESE. If subsequent registration forms need to be submitted for the FESE due to errors in the first submission or changes of FESE details, the number specified at the end of the filename should be incremented accordingly otherwise the registration form will be rejected.
Please fill in each gray zone of the document. When entering information for a field, press “F1” to receive additional help on how to complete the field. Use Tab key to navigate between fields.
The form will be reviewed by MasterCard and the result will be a registration of the submission complete with a unique identifier and entry into the Mobile MasterCard database.
MasterCard will issue a Mobile Evaluation Plan Summary (MEPS) which defines the tests and evaluations that are required for the registered FESE based on the information submitted in this form.
A MEPS is typically issued within 5 business days after receiving the correct registration form.
These procedures supplement other written MasterCard policies and procedures that apply to this subject. Accordingly, compliance with these procedures does not remove the obligation to comply with such other MasterCard policies and procedures.
Submitting entity details
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A.1
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Company Legal Name
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A.2
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Company Address (including ZIP/Postal code)
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A.3
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Contact name
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A.4
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Contact Email Address
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A.5
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Contact Telephone Number
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Submission Details
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A.6
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Submission date(mm-dd-yyyy)
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A.7
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Product Architecture Submitted
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A.8.1
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Registration Type
(Indicate if LoA is the purpose of the registration or not)
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Formal Type Approval (LoA)
Formal Selective Testing for Trial/Pilot (Waiver)
Renewal of LoA
End of Life LoA
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A.8.2
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If Registration Type = Renewal or End of Life, please provide the original MasterCard registration number.
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A.8.3
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If Registration Type = End of Life, please indicate the requested volume for the RMPCN
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A.8.2
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Public or Private product.
(If approved, Public products will be listed on MasterCard’s web site.)
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A.9
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Is this product a variant of a previously registered/approved product due to hardware or software changes?
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(If yes please complete A.9.1 – A.9.2)
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A.9.1
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Registration number of previously registered/approved product
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A.9.2
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Brief description of hardware/software differences
(Additional information can be supplied in a separate document e.g. architecture document showing the changes)
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Product Summary
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A.10
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Product manufacturer name if different from Company Legal Name (A.1)
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A.11
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Product technical name and version
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Name
Ver.
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A.12
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Product commercial name and version
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Name
Ver.
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A.13
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OS Type
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A.14
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Operating System (OS) name and version number
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Name
Ver.
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A.15
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Payment Application name and version
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Name
Ver.
Build :
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A.16
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Application Specification Type
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A.17
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Manufacturing facility name and location
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A.18
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Is the chip used inside this product licensed by Cryptography Research Inc. (CRI) under CRI's patent portfolio related to differential power analysis (DPA) and related external monitoring attacks?
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CAST Evaluation Details (Supply A.21 and A.22 (for existing CAST) or A.21 & A.23~A.28 (for CAST Registration) )
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A.20
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CAST status
For details of CAST process see here.
(In case of Refresh CAST please provide a valid PCN in B13.1)
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Pre-existing CAST
Register a new CAST
Register a Refresh CAST
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A.21
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Product Name and Version used for CAST registration
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Name
Ver
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A.22
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CAST Mobile Payment Certificate Number (MPCN)
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A.23
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Evaluation Laboratory
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A.24
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Report Number
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A.25
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Contact Name
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A.26
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Telephone
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A.27
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Anticipated date for report submittal to MasterCard (mm-dd-yyyy)
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A.28
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User Guidance Details.
Document description & Unique Reference(s)
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