To use the MasterCard Payment Gateway you must have a Merchant ID number for e-commerce with one of the Acquiring Banks that we connect to.
To use the MasterCard Payment Gateway Services Direct Debit service you must have an Originator ID number that has been issued by your Sponsoring Bank.
Please allow 10 minutes to complete this application. If you have any further enquiries please contact our Sales Team on 0870 72 74 761. Fields marked in BOLD are mandatory. We are unable to process your application if you send us incomplete information.
Please do not submit this form until you have a merchant ID Number / Originator ID Number. Fields marked in BOLD are mandatory
2. CONTACT DETAILS
Company Name:
Trading as:
(If different from above)
Address:
Country:
Postcode:
VAT No: Registration No:
Are you an existing MasterCard Payment Gateway Services Customer?
YES NO Contact Name: Job Title: Work Telephone: Mobile: General Email: Technical Email: 1. COMPANY DETAILS
4. SERVICES Contact Name: Telephone: Email: Address: Country: Postcode: 3. BILLING DETAILS
Please tick the Value Added Services that you require:
Real Time Fraud Screening 3-D Secure
Age Identity Verification Bin Range Restriction Ceiling Limits
FRAUD PREVENTION
Payment Tokenization (Pre-Registered Card) Card Tokenization
TOKENIZATION SOLUTIONS
Credit / Debit Card Continuous Authority Direct Debit Continuous Authority
5. DIRECT DEBIT & DIRECT CREDITS 4. SERVICES (CONT.)
YES, I require the Direct Debit Service YES, I require the Direct Credit Service American Express
Corporate Purchasing Cards Visa Electron
Laser Diners
ADDITIONAL CARD TYPES
Transax Cheque Guarantee Batch Processing
Split Shipment
Chargeback Management e-Wallet Solutions
Dynamic Currency Conversion
OTHER SERVICES
e-Vouchers
Online cash transactions
PREPAY SOLUTIONS Originator ID No (OIN): Sponsoring Bank: OIN Type:
AUDDIS AUDDIS PAPERLESS Please supply one e-mail address in which the electronic notification(s) should be sent. Email:
To ensure that you receive electronic notification of failed DD setups, please make sure you have completed section 6 of the BACSTEL IP form from your sponsoring bank.
Please enter your Merchant ID Number(s), given to you by your acquiring bank, for e-Commerce and/or Mail / Telephone Order (if applicable). Enter the 3 digit currency code in the boxes below that you wish to trade and settle in.
Please confirm whether your MID is being used for Gaming authorisations (SIC: 7995)
YES NO
Please confirm which country your MID is registered to?
6. MID REQUIREMENTS
MERCHANT
ID NUMBER MID TYPE TRADE IN SETTLE IN
ACQUIRING BANK MERCHANT CATEGORY CODE (MCC) COUNTRY CODE Further requirements:
7. MASTERCARD PAYMENT GATEWAY SERVICES ANNOUNCEMENTS
6. MID REQUIREMENTS (CONT.)
MasterCard Payment Gateway Services announcements are sent in the event of any changes occurring that may affect the service you receive from MasterCard Payment Gateway Services, its partners or acquiring banks used. This will include details of system status updates and scheduled maintenance notifications.
It is recommended that you set up a mailing list at your company of the form: 'mpgs@yourcompany. com' with all interested parties subscribed. This ensures that announcements will be received even if a key member of staff is not available.
This information will be used solely for the
purpose of informing you of important operational information, and will not be used for marketing purposes.
YES I would like to receive MasterCard Payment Gateway Services announcements to the following E-mail address:
NO I do not wish to receive MasterCard Payment Gateway Services announcements
Bank account in which the monies are to be settled. Bank Name: Bank Address: Sort Code: Account Number: Purchase Order:
8. TECHNICAL INFORMATION
From which IP Address will you submit transactions to MasterCard Payment Gateway Services?
E-Commerce website:
Description of products/services you will be selling via the account:
9. MASTERCARD PAYMENT GATEWAY SERVICES REPORTING SYSTEM
Please supply details of the person who will administer MasterCard Payment Gateway Services Reporting Accounts for your organisation.
IP Address to access Reporting:
Reporting Username:
(Alphanumeric Characters only, max 20) Forename: Surname: E-mail Address: Telephone Number:
11. CONFIRMATION 10. ADDITIONAL INFORMATION
How did you find MasterCard Payment Gateway Services?
From existing customer (*) Bank recommendation (*) IBS Software Services (P) Ltd Telesales / Sales Call
Search Engine / website Reseller (*)
Other
If other or marked (*) please specify
Your Comments:
Please do not submit this form until you have a Merchant ID Number.
I hereby declare the above information to be true and complete