<p> Light Card Capabilities Form V2.00 – October 4th, 2013</p><p>Purpose of this document</p><p>As part of the Vendor Product Approval Process, this form aims at gathering in a very synthetic document the features required to request a Letter of Approval in case the product already passed the Interface and Application Testing and the Compliance Assessment and Security Testing.</p><p>This Light Card Capabilities Form (Light CCF) shall be provided to MasterCard in Microsoft Word format only at: [email protected]</p><p>For guidance on how to fill in this form please refer to the ‘Light CCF – User Guide’ document available on request.</p><p>By supplying this form the Vendor agrees that the product strictly follows the description below and that the technical configuration of the application is strictly identical to the one defined during the initial approval.</p><p>Revision History</p><p>Please record changes made between different versions of the registration form Date Version Author Comments</p><p>Registration Information</p><p>Fields in Red are Mandatory. Fields in Blue are Optional or Conditional depending on the product.</p><p>Submitting entity details</p><p>A.1 Company Legal Name Company Address A.2 (including ZIP/Postal code and country) A.3 Contact name A.3.1 Contact Email Address A.3.2 Contact Telephone Number</p><p>Submission Details</p><p>A.4 First submission date (mm-dd-yyyy)</p><p>A.5 Is this a renewal request? (If yes please complete A.5.1) If Yes: fill in the Registration Number or A.5.1 CFA Summary A.6 Registration number of the “father” product A.7 Additional Vendor’s Comments</p><p>Product Summary</p><p>Name: A.8 Product Technical Name and Version Version:  Note: The Product Technical Name and Version must identify a unique product. Product Commercial Name and Version Name: A.9 Version: Product Name and Version used for CAST Name: A.10 registration Version: A.11 This product is registered as Name and Version of Application Specification A.12 used for the product development if NMC (specifications reference): A.13 Operating System Type A.14 Operating System Supplier Name: A.15 Operating System Name and Version Version: X value: A.15.1 If MULTOS OS Y value: AMD vers. A.16 Payment Application Supplier Name: A.17 Payment Application Name and Version Version: Name: A.18 Product patch (if applicable) Version: A.21 Licensed by Cryptography Research Inc. (CRI)</p><p>CCF Version 5.00 ©2013 MasterCard Page 2 of 3 MasterCard Worldwide Chip Centre of Excellence</p><p>Card Capabilities Form</p><p> under CRI's patent portfolio  Note: The Integrated Circuit used by this product and identified in the below field T5 (page 7) has been licensed by Cryptography Research Inc. (CRI) under CRI's patent portfolio related to differential power analysis (DPA) and related external monitoring attacks. Any information request or question related to CRI licensing shall be addressed to your IC supplier. Contact interface details C.8 Contact Protocols supported Contactless Interface details Contactless Communication Protocol C.13 Specification version supported Submitting entity details B.1 Product Type B.2 Form Factor</p><p>Technology Identifier</p><p>Production Site (City Component Supplier CQM Label / Country) (Name / Version) Chip B.3 B.4 B.5 B.6 1 Module B.7 B.8 B.9 B.10 2 </p><p>Antenna / Antenna B.11 B.12 B.13 n/a Inlay Inlay B.14 B.15 B.16 B.17 6 Lamination B.18 B.19 n/a B.20 7 ID-1 Card Card Body B.21 B.22 n/a B.23 3 Embedding B.24 B.25 n/a B.26 4 </p><p>______END OF FORM ______</p><p>CCF Version 5.00 ©2013 MasterCard Page 3 of 3</p>