PayPass Product Configuration Update Form
This form is used by a vendor when:

A new PayPass Product is submitted to the PayPass Approval process using one or more already successfully tested Product Components
(PCD, EP Module, PayPass Application Kernel, other Payment System Application Kernel or PED)

A PayPass Product is submitted for renewal of an expiring PayPass Letter of Approval or when changes have been made to the already
approved PayPass Product
The form identifies the components of the new configuration and the already approved components. The vendor shall include proof of
approval including existing Test Assessments, EMVCo LoA, EMV EP Compliance Label, TQM Label, PCI-PED approval.
VENDOR IDENTIFICATION
Company Name
Address 1
Address 2
City
State or Province
Postal Code
Country
Contact Name
Work Phone
Cell Phone
Fax Number
e-mail Address
©2009 MasterCard
PayPass Configuration Update Form  Version 1.2 - September 2009
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PREVIOUS CONFIGURATION
PCD/Terminal
Configuration
Please tick as many boxes
as needed
Fully Integrated
Terminal
Intelligent
Contactless Reader
Terminal &
Transparent
Contactless Reader
Remarks:
NEW UPDATED CONFIGURATION
Fully Integrated
Terminal
Intelligent
Contactless
Reader
Terminal &
Transparent
Contactless Reader
Remarks:
PREVIOUS CONFIGURATION
NEW UPDATED CONFIGURATION
PayPass Product Identification
PayPass Product Identification
Marketing Name
Name/identifier
Version
Marketing Name
Name/identifier
Version
Terminal
Card Reader
PayPass LOA #
©2009 MasterCard
PayPass Configuration Update Form  Version 1.2 - September 2009
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PREVIOUS CONFIGURATION
NEW UPDATED CONFIGURATION
PCD Identification
PCD Identification
Name
Version
Name
Version
PCD-ID
PCD HW-ID
PCD SW-ID
Related Test
Assessment or
EMVCo LOA #.
Related TQM Label #
PREVIOUS CONFIGURATION
NEW UPDATED CONFIGURATION
PED Identification
PED Identification
Name
Version
Name
Version
PED Model
PCI Approval Ref
©2009 MasterCard
PayPass Configuration Update Form  Version 1.2 - September 2009
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PREVIOUS CONFIGURATION
NEW UPDATED CONFIGURATION
Entry Point Module
Entry Point Module
Name
Version
Name
Version
Entry Point Module
(if PayPass Product
supports it)
EMV EP Compliance
Label Reference
Number
(if PayPass Product
supports it)
PREVIOUS CONFIGURATION
NEW UPDATED CONFIGURATION
PayPass Application Kernel Identification
PayPass Application Kernel Identification
Name
Version
Name
Version
Application Kernel
Test Assessment-L2
ref
©2009 MasterCard
PayPass Configuration Update Form  Version 1.2 - September 2009
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PREVIOUS CONFIGURATION
NEW UPDATED CONFIGURATION
Other Payment System Application Kernel Identification
Other Payment System Application Kernel Identification
Name
Version
Name
Version
Other Payment
System Application
Kernel(s)
(Only if PayPass
Product supports the
EMV Entry Point)
Changes Impacting the PayPass Terminal Product
Please list any changes made to the software which could have an impact on the PayPass Terminal Product:
-
Indicate if the change is minor or major
-
Give a description of the change and its impact
-
List any tests performed to prove there is no regression impact on [PayPass M/CHIP]
Reference attached documentation in the column ‘Description’, if any.
No
Yes
Minor/ Major Description
Impact
Tests performed
Have you made a change in an area of the
product software that is subject to TTA Level 2
tests?
Have you made a change that requires recompilation of the application software?
©2009 MasterCard
PayPass Configuration Update Form  Version 1.2 - September 2009
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Changes Impacting the PayPass Terminal Product
Have you made a change to the Entry Point
Module?
Only if PayPass Product supports the EMV Entry
Point)
Have you added or modified another Payment
System Application Kernel?
Only if PayPass Product supports the EMV Entry
Point)
Have you made a change in the software that is
not subject to the test, e.g. a change in
parameters or a change in the protocol between
the PayPass Product and acquirer host?
In the situation where the PayPass Application is
supported in a terminal connected to a card reader
embedding the PCD, have you made a change in
an area of the card reader software that is subject
to TTA Level 2 tests?
I hereby declare that the information contained in this form is correct and complete.
Name:
Signature:
Position:
Date:
Note: The information in this annex was valid at the time of publication. MasterCard reserves the right to amend this information
and release new versions or updates without prior notification.
©2009 MasterCard
PayPass Configuration Update Form  Version 1.2 - September 2009
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It is the vendor’s responsibility to check for new versions or updates at www.paypass.com before commencing the vendor testing process and
submitting products for formal testing.
©2009 MasterCard
PayPass Configuration Update Form  Version 1.2 - September 2009
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