Please enter the following: Name of QIR Company, QIR Individual Name, Description of services provided by QIR
Does your company share cardholder data with any third-party service providers?
Please upload a file containing the following information regarding the third-party service providers your company shares cardholder data with: Name of service provider, Description of services provided
Merchant certifies eligibility to complete this shortened version of the Self-Assessment Questionnaire for this payment channel
Please upload a file containing the following information regarding the Payment Applications your organization uses: Payment Application Name, Version Number, Application Vendor, Is application PA-DSS Listed?, PA-DSS Listing Expiry date (if applicable) and type “Continue” when finished
Please describe the environment covered by this assessment at a high level
Does your business use network segmentation to affect the scope of your PCI DSS environment?
Does your company use a Qualified Integrator and Reseller (QIR)?
Does the organization use one or more Payment Applications?
Which payment channels are covered by this assessment (check all that apply)?