Home
Forms Library
If you do not wish to have the PCI Compliance Program - TD Bank

If you do not wish to have the PCI Compliance Program - TD Bank 2025

If you do not wish to have the PCI Compliance Program - TD Bank Preview on Page 1

See details

4.5 out of 5

58 votes

The document outlines the process for a merchant to opt out of Data Breach Insurance coverage provided by TD Bank Merchant Services. It requires the merchant to fill out and submit an opt-out form, indicating their decision to decline coverage. If not submitted, the merchant will automatically receive the insurance. The document also states that by opting out, the merchant accepts responsibility for any costs related to data breaches.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out If you do not wish to have the PCI Compliance Program - TD Bank

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open it in the editor.
Begin by checking the box next to 'I Decline' to indicate your decision regarding Data Breach Insurance Coverage.
In the 'Merchant Account Number(s)' section, enter your merchant account numbers. Ensure that each number is accurate for proper processing.
Next, fill in your 'Business Name' as registered with TD Bank. This ensures that your request is correctly associated with your business.
Provide an 'Authorized Signature' where indicated. This signature must be from someone authorized to make decisions on behalf of your business.
Finally, enter the date of signing in the designated field. This is important for record-keeping purposes.
Once completed, you can either mail this form to TD Bank or fax it using the provided contact information.

Start using our platform today for free and streamline your document management!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What happens if I dont do PCI compliance?

If you dont comply with PCI DSS security standards, your business could face serious consequences. Non-compliance is a data bdocHub risk. It can result in huge fines, customer loss of trust, and even being barred from processing transactions.

How do I avoid PCI compliance fee?

Steps to PCI Compliance: Use approved payment devices. Utilize validated payment software. Avoid storing sensitive cardholder data. Implement and maintain firewalls on all systems. Ensure your wireless networks are encrypted and password-protected. Use strong, unique passwords for all systems and devices.

What happens if you dont have PCI compliance?

To put it simply, youll likely get fined and youll no longer be able to accept payment cards if youre not compliant with PCI DSS regulations.

What happens if we dont comply with data security standards?

Non-compliance penalties can range from $5,000 to $100,000 per month (roughly 4,000 to 80,000 in GBP). The specific amount is decided based on several factors, including the size and nature of your business, and the extent of your non-compliance.

Do you legally have to be PCI compliant?

Every business that takes credit card payments must be PCI compliant. If your business isnt, it can lead to serious problems including fines.

What are the consequences of PCI non compliance?

Many compliance regulations hold companies accountable for bdocHubeseven if the source was a third-party vendor. Failure to ensure third-party compliance can result in hefty fines and reputational damage.

Is TD Bank PCI compliant?

PCI Compliance information and resources TD Bank works with SecurityMetrics, a leading provider of data security tools to help you achieve PCI compliance.

If you do not wish to have the PCI Compliance Program - TD Bank 2025

Here's how it works