Integration Partner - Client Introduction Form
Integration Partner:

Integration Partner Contact Details

Client Name:
Number of Tills & ATM: (cardholder present only)

MID Requirements of your client

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. If you are unsure of which ones to use please click here.
Please confirm whether your MID is being used for Gaming authorisations (SIC: 7995)
  YES NO
Country :
Merchant ID Number MID Type Trade In Settle In Acquiring Bank
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Please tick the Value Added Services your client requires
Fraud Prevention Recurring Transactions
Real Time Fraud Screening
3-D Secure
Age and Identity Verification
Bin Range Restriction
Ceiling Limits
Credit / Debit Card Continuous Authority
Direct Debit Continuous Authority
Tokenization Solutions
Payment Tokenization (Pre-Registered Card)
Card Tokenization
Card Types Additional Card Types
Maestro
MasterCard Debit
MasterCard
Visa Electron
Visa Delta
Visa
Solo
American Express
Diners(e-commerce only)
Corporate Purchasing Cards
Laser
Cardholder Present Services Other Services
Batch Processing
Reversals
Velocity Limit Zero
Batch, Reversals, and Velocity are all required for CP processing.
Chargeback Management
Dynamic Currency Conversion
e-Vouchers
Online cash transactions
Split Shipment
PayPass Online
 

Direct Debit & Direct Credits

 
YES, I require the Direct Debit Service.
YES, I require the Direct Credit Service.
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.
e-mail address:

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.

 
Bank account in which the monies are to be settled (Barclays Only)
Additional Information / Accounts:
MasterCard Payment Gateway Services Reporting System
Please supply details of the person who will administer MasterCard Payment Gateway Services Reporting Accounts for your organisation.
Existing GroupName: (optional)
Description of products/services being sold / provided
Additional Information
Your Comments:
Confirmation
Please do not submit this form until you have a Merchant ID Number.
I hereby declare the above information to be true and complete.
Please enter your name here:


 
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