MOTO Addendum

Your Sales Consultant*

Underwriting & Marketing Review

Please answer the following questions as accurately as possible.

Sample(s)*

Submit sample(s) of product brochure, promotional materials, product catalogue, etc. How will product be advertised or promoted? (If advertising on the internet, provide website address)

Name(s) and Address(es)*

List name(s) and address(es) of vendor from which the product is purchased

Product(s) or Service(s)*

What product(s) or service(s) does your organization provide the cardholder? (please be specific)

How does the customer order the product/service?*

Please provide the process from customer order to shipment

What is your return/refund/cancellation policy?*

How long after credit card authorization is the transaction completed?*

How long after the transaction is completed do you ship the goods or provide the service?*

Does the customer sign a contract specifying terms and conditions?*

Yes
No

If yes, please provide a copy of the contract.

Please attach in either PDF or Word (.doc, .docx) format.

Accepted file types: pdf, doc, docx, Max. file size: 20 MB.

Do you perform recurring monthly billing?*

Yes
No

If yes, how often do you perform recurring monthly billing?

Quarterly
Bi-annual
Annual

Does your database collect entire credit card numbers?*

Yes
No

If Yes, are you PCI compliant?*

Yes
No

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