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