F 1486
CARD-NOT-PRESENT MERCHANT INFORMATION FORM
Date:_____________________
Dear Sir/Madam,
We thank you for your application for a MCB merchant electronic commerce facility which
will enable you to accept ‘Card-Not Present’ transactions, hereto referred as CNP
transactions, in an online secure environment.
In this respect you are kindly requested to complete Appendix I below and send the form
to:
CARDS SBU
8TH FLOOR, MCB ST JEAN BUILDING
THE MAURITIUS COMMERCIAL BANK LTD
QUATRE BORNES, MAURITIUS
The information you will be providing will be used for the sole purpose of processing your
application and is necessary to:
 assess your business as a potential electronic commerce (e-commerce) merchant of
the bank
 understand and support your business.
If you need any further information, or require any assistance in completing this form,
please call us on +230 2025000. You may also email us to ecom@mcb.mu
Cards SBU
The Mauritius Commercial Bank Limited
1
9-15 Sir William Newton Street, Port Louis, Republic of Mauritius T: +230 2025000 F: +230 2087054 E: contact@mcb.mu
Swift Code MCBLMUMU BRN: C07000934 www.mcb.mu
Appendix I
1.
ABOUT YOUR BUSINESS
Business Legal Name
Business Trading Name
(if different from above)
Company Registration
Number
Country of Incorporation
Date of Incorporation
Structure of Business
�
�
�
�
�
private company (Ltd)
partnership
public limited company (plc)
sole trader
other (please
specify)_________________
Directors/Partners,
Significant Shareholders *,
Signatories
Registered Address of the
business
Telephone Number
Fax Number
Email Address
VAT Registration Number
(if applicable)
*Shareholders holding 20% or more of the capital or voting rights in the company, if it is a publicly listed company
The Mauritius Commercial Bank Limited
2
9-15 Sir William Newton Street, Port Louis, Republic of Mauritius T: +230 2025000 F: +230 2087054 E: contact@mcb.mu
Swift Code MCBLMUMU BRN: C07000934 www.mcb.mu
2.
TRADING INFORMATION
Trading Address
(if different from
registered address)
Date Trading Commenced/ To
Commence
Number of Full Time Staff
Reason for leaving former
processor [if applicable]
Description of Business
Activities/Services/Products
You Provide/Intend to
Provide
How Do You Provide/Intend
to Provide the Above?
� At the Counter
� Mail/Telephone Order
� Internet
Average Time Between
Receipt and Fulfillment of
Order
Do You Offer Any of the
Following?
�
�
�
�
�
�
�
�
Product Guarantees
Refund policy
Return policy
Delivery policy
Deposits
Memberships
Subscriptions
Other (please specify)_________________
If you offer any membership or
subscription services please
provide details
The Mauritius Commercial Bank Limited
3
9-15 Sir William Newton Street, Port Louis, Republic of Mauritius T: +230 2025000 F: +230 2087054 E: contact@mcb.mu
Swift Code MCBLMUMU BRN: C07000934 www.mcb.mu
Any Existing acquiring relationship? – Payment by Cards
If Yes,
None
At the Counter
�
Already accept
Mail/Tel Order
�
Internet
�
�
Name of Acquiring Bank
___________________________________________
Years in business
___________________________________________
Chargeback Ratio
___________________________________________
Fraud Ratio
___________________________________________
Virtual POS
�
Need to accept
Mail/Tel Order
�
Visa
�
�
Currencies in which Your
Business Activities /
Services/Products Will Be
Displayed and Sold
Marketing Channels
Money Request
�
MasterCard
Need to accept
Online Payment
�
Amex(USD, MUR)
�
MUR
USD
EUR
GBP
Other (please specify) ________________
� Newspapers/Magazines
� Television/Radio
� Yellow Pages
� Direct Mail
� Internet
� Other (please specify) ________________
The Mauritius Commercial Bank Limited
4
9-15 Sir William Newton Street, Port Louis, Republic of Mauritius T: +230 2025000 F: +230 2087054 E: contact@mcb.mu
Swift Code MCBLMUMU BRN: C07000934 www.mcb.mu
CARD-NOTPRESENT
MERCHANT
APPLICATIO
N FOR
3.
MARKETING AND WEBSITE SERVICES
Please detail all the membership
packages and prices available
Do you offer free trial
memberships?
Please describe your strategy on
end of the free trial membership
[if
]
Doapplicable
you require
registration and
credit card details before the free
trial membership?
� Yes
� No
� Yes
� No
If yes do you send it for preauthorization?
Do you offer tangible goods?
� Yes
� No
How do you receive your
customer's order? Internet/
mail/telephone order
How are orders processed?
Target market [major markets
targeted]
4.
TECHNICAL INFORMATION
Website Address
Does the website owner control
the site content?
� Yes
� No
Do you provide services to
websites that are not fully
owned by you?
� Yes
� No
Level of Cryptography Used to
Protect Account Data on Your
Website
(minimum of 128 bit SSL is
required)
Are You Already Fully Certified
For Verified by Visa/MasterCard
SecureCode? **
If yes, please provide date of
certification.
� Yes
� No
Date of Certification:
**If you are not already certified for Verified by Visa and MasterCard SecureCode, we will send
your data for registration should you wish to proceed with the implementation of our online
payment gateway.
The Mauritius Commercial Bank Limited
5
9-15 Sir William Newton Street, Port Louis, Republic of Mauritius T: +230 2025000 F: +230 2087054 E: contact@mcb.mu
Swift Code MCBLMUMU BRN: C07000934 www.mcb.mu
5.
FINANCIAL INFORMATION
Total Annual Business
Turnover * ** (all sales channels)
Total Value of Annual Online
Sales***
**
* Number of Annual Online
Total
Sales***
Transactions
Estimated lowest ticket
value***
Estimated highest ticket
value***
Estimated average ticket
value***
***Current or expected data to be filled in.
6.
BANKING INFORMATION
Once you are set up as an e-commerce merchant, you will need to open a bank
account with the MCB in each of the currencies in which you would like to be
settled. You may also wish to register for our internet banking facility, which will
enable you to monitor your bank accounts remotely.
Do You Already Have a
Banking Relationship with the
MCB?
� Yes
� No
In Which Currencies Would
You Like to be Settled
�
�
�
�
�
7.
MUR
USD
EUR
GBP
Other (please specify) ________________
CONTACT INFORMATION
A.
BUSINESS
The details of your business contact will be used to send you important information relating
to the implementation of our online payment gateway
Name
Job Title
Email
Telephone
Mobile
Address
B.
IN-HOUSE ADMINISTRATIVE/TECHNICAL OR THIRD-PARTY
The details of your in-house administrative or technical contact (if different from
your business contact) or your third party contact (who will integrate your
website with our online payment gateway) will be used to send you technical
information relating to the integration of our online payment gateway into your
website.
The Mauritius Commercial Bank Limited
6
9-15 Sir William Newton Street, Port Louis, Republic of Mauritius T: +230 2025000 F: +230 2087054 E: contact@mcb.mu
Swift Code MCBLMUMU BRN: C07000934 www.mcb.mu
Contact:
� In- House (Administrative/Technical)
� Third-Party Integrator
Name
Job Title
Email
Telephone
Mobile
Address
If a third-party integrator is used, please insert the company name as well as the name of the contact person
C.
ACCOUNTS
The details of your accounts contact (if different from your business contact) who
will deal with the monthly billing aspect of your business.
Name
Job Title
Email
Telephone
Mobile
Address
8.
CUSTOMER SUPPORT
Methods of delivery
Where are stocks of products
kept?
Where products are sourced?
Does supplier has appropriate
license?
� Yes
� No
Does your company fulfill the
orders directly?
� Yes
� No
If no please provide fulfillment Company Name:
company details
Address:
Contact Name:
Telephone:
Email Address:
How do you prove delivery?
The Mauritius Commercial Bank Limited
7
9-15 Sir William Newton Street, Port Louis, Republic of Mauritius T: +230 2025000 F: +230 2087054 E: contact@mcb.mu
Swift Code MCBLMUMU BRN: C07000934 www.mcb.mu
9. Documents Required

Due diligence documents of the directors, shareholders and beneficial owners
including: cv/copy passport/bank reference/proof of address

6 months processing statements showing chargebacks [details of previous
relationship with an acquirer, name of acquirer ,sales volume, chargeback and fraud history]

Financial statements [Profit & Loss/Balance Sheet/cash flow]
[audited preferred]
for the past 2 yrs

Copy of certificate of incorporation for existing parent company

Incorporation documents showing directors & shareholders and beneficial owners

Detailed business plan including operations review/organisational structure/ financial
highlights/ credit card security procedures/ resumes of key members of the mgt team
The WHO IS?


Copies of any relevant licenses, agency agreements, reseller/
agreements
10.
distributorship
SPECIFIC SPECIFICATIONS AND WARANTIES

The merchant is not engaged in or affiliated with any business products or methods of
selling other than those listed in this application.

No owner with voting control of the company, or with more than 5% of the shares,
nor any signatory to this application or senior officer of the merchant's organization, has been
charged, arrested, or convicted within the last five years of any criminal activity.

The merchant has not been terminated by other banks processors or third parties for
the business indicated in this merchant application as well as for other businesses.

All information has been provided accurately and without omissions or misleading
statements and no information has been withheld.
11.
CONFIRMATION OF APPLICATION
I/We hereby apply to be registered as a merchant on the MCB online payment gateway, and
certify that the information furnished is true, accurate and complete. I/We undertake to notify
the bank immediately in the event that there are any changes in any of the above information.
Authorised Signature (1) _________________________ (2)___________________________
Name (1) ___________________________________ (2) _____________________________
Date:_______________________________________
For and on behalf of: __________________________________________________________
(Full name of Company, Society or Association)
The Mauritius Commercial Bank Limited
8
9-15 Sir William Newton Street, Port Louis, Republic of Mauritius T: +230 2025000 F: +230 2087054 E: contact@mcb.mu
Swift Code MCBLMUMU BRN: C07000934 www.mcb.mu