Card Not Present (MOTO) Form

Mail Order / Telephone Order [MOTO] / Internet Transactions Addendum To Merchant Bankcard Application

(This form must be completed by all merchants processing > 40% of keyed transactions)

Business Name

Note: This phone number will be printed on your customer’s credit card statement.

Mail Order / Telephone Order Activities

Do you use a Fulfillment Center to handle your MOTO by: (check any or all that apply)
Fulfillment Center Name

Please describe your fulfillment procedures:

How do you solicit or advertise your product(s) and/or services? (check any or all that apply)