Product Registration Questionnaire: Platform Providers

Instructions: P lease complete all sections. Each platform configuration (e.g. IC, OS version, applications) must be submitted on separate forms. F or additional instructions refer to the attached Registration Questionnaire Instructions. Return completed Pr oduct Registration Questionnaire, as a PDF, by email to the EMVCo Security Evaluation Secretariat. Email: securityevaluation@emvco.com 1. General Information: Company Name: FORMTEXT           Security Lab oratory Name: FORMTEXT           Publishing Approval: FORMCHECKBOX Yes please include in the Approved Product list. FORMCHECKBOX No please exclude from the Approved Product list. 2. Type of E valuation: New product evaluation FORMCHECKBOX For derivatives, please provide parent PCN: FORMTEXT           Update evaluation FORMCHECKBOX Please provide P CN: FORMTEXT           Product already issued in the field: Yes FORMCHECKBOX No FORMCHECKBOX Renewal evaluation FORMCHECKBOX Please provide P CN: FORMTEXT           Extension of expired certificate FORMCHECKBOX Please provide PCN: FORMTEXT           3. Product Information: EMVCo considers a platform product to be made up of a base operating system residing on a n Integrated Circuit (without applications).

3.1 Product I dentification: Product name: FORMTEXT           Product version: FORMTEXT           3.2 IC Product: IC part number: FORMTEXT           IC version: FORMTEXT           IC Manufacturer: FORMTEXT           ICCN detail: FORMTEXT           3.3 Operating System: OS name: FORMTEXT           OS version: FORMTEXT           Post issuance capability: FORMCHECKBOX Yes FORMCHECKBOX No OS update capability: FORMCHECKBOX Yes FORMCHECKBOX No Type of OS: FORMCHECKBOX Java Card FORMCHECKBOX Multos FORMCHECKBOX Proprietary 3.4 GlobalPlatform C ompliance: GP version: FORMTEXT           GP Amendments: FORMTEXT           3.5 Applications in S cope: Please provide references and versions of all applications included in the scope of evaluation, as defined in SEWG Bulletin 1 3 (see also instructions section below): Application reference Application version FORMTEXT           FORMTEXT           FORMTEXT           FORMTEXT           FORMTEXT           FORMTEXT           FORMTEXT           FORMTEXT           FORMTEXT           FORMTEXT           FORMTEXT           FORMTEXT           3. 6 User Guidance D etail: Please provide references and versions of all User security guidance documents applicable to the product: Document(s) reference / version: FORMTEXT           FORMTEXT           FORMTEXT           FORMTEXT           FORMTEXT           FORMTEXT           FORMTEXT           4. Contact Information: Contact Name: FORMTEXT           Contact email: FORMTEXT           Date Completed: FORMTEXT           5. Authorized b y: Name: FORMTEXT           E mail: FORMTEXT           Date Authorized: FORMTEXT           Instruction s for Platform Registration Questionnaire 1. Company Name: Enter the name of the company that has registered with EMVCo as a chip provider Security Lab oratory Name: Enter the name of the Security Evaluation Laboratory you plan to use for the security evaluation of your p roduct. Publishing Approval: Indicate if you want your approved Platform listed on the Approved Products list that is posted to the EMVCo "public" website: or if you would like to have your Platform approval kept "private" and not included in the approved products list. 2. Type of evaluation: Indicate if the questionnaire is for a new platform, for a renewal, provides information about changes that have been made to an existing approved product, or concerns a refresh evaluation for an expired certificate. For the three last cases pl ease provide the current P CN number. In the case of a n update, indicate whether pieces of the approved product have been issued to the field or not (if so a derivative PCN will be assigned).

3.1 Product identification: Enter the product name and version uniquely identifying the product, to be used by EMVCo for the certificate.

3.2 IC Product: Enter the IC Part Number and version, the name of the IC manufacturing company, and the ICCN details assigned by EMVCo to the IC.

3.3 Operating System: Enter the name and version of the OS associated with the product. A lso indicate if the product support s "Post Issuance c apabilit y", whether it features an "OS update" mechanism or not, if the OS was developed to meet the Java Card or Multos specifications, or if it is proprietary.

3.4 GlobalPlatform compliance: Enter the version of the GlobalPlatform specification the product is developed to be compliant to, as well as the appropriate GP amendments if applicable.

3.5 Applications in scope: Enter the identifier and version of the application(s) providing platform related services or functionalities (as d efined in EMVCo SEWG Bulletin 13) included in the scope of the platform evaluation.

3.6 User Guidance Detail: Enter the name of the document (s) that provide ( s) security guidance to the product users to remain within the scope of the approved product configuration. 4. Contact Information: Enter the name and email of the perso n EMVCo should contact if there are any questions related to the information provided on the questionnaire. Please enter the date the questionnaire was completed. 5. Authorized By: Enter the name of the person that authorizes the testing of the product detailed in the questionnaire.