Who can sign the attestation?

An authorized officer or designated security/compliance owner should sign the attestation. The signer must have authority to commit the organization and should be identified by name, title, and authorization method in the report.

Are eSignatures valid for this report?

Yes. Electronic signatures are legally recognized under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, provided intent, consent, attribution, and record retention are satisfied.

Which evidence files are essential?

Include configuration snapshots, vulnerability scan reports with scan IDs, firewall rules, segmentation proof, and remediation logs. Explicitly reference each file in the control-testing section to simplify review.

Can I submit scanned PDFs?

Yes. Scanned PDFs are acceptable if they are legible and accompanied by metadata (creation date, source). Native export formats from scanning tools are preferred when available.

What level of signer authentication is recommended?

Use an authentication method that matches your acquirer’s expectations—email+SMS code, SSO, or stronger identity proofing for critical attestations reduce rejection risk.

How do I handle remediation after the report?

Document remediation steps, assign owners and deadlines, and include verification evidence (re-scans, configuration changes) in a post-assessment addendum to the report.

Electronic Signature
Templates
Miscellaneous
Compliance PCIDSS Report

Compliance PCIDSS Report

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Compliance PCIDSS Report

This Compliance PCIDSS Report and Agreement (the "Agreement") is entered into as of by and between (Client) and (Assessor).

WHEREAS:

WHEREAS, Client operates payment cardholder data environments and requires an assessment to determine conformity with the Payment Card Industry Data Security Standard (PCI DSS); and

WHEREAS, Assessor is qualified to conduct PCI DSS assessments and to prepare a formal Compliance Report documenting findings, evidence and recommended remediation; and

WHEREAS, the parties desire to set forth the scope, deliverables, payment terms and legal terms governing the assessment and delivery of the Compliance PCIDSS Report.

1. Scope of Work

Assessor will perform a PCI DSS assessment and prepare a written Compliance Report that documents scope, testing performed, findings, evidence reviewed, and remediation recommendations. The Assessment will include on-site review as indicated in the scope below and remote verification where feasible.

Scope of Services Systems and Locations Included in Scope PCI DSS Version (select all applicable)

3.2.1 4.0 Other:

2. Assessment Details and Findings

Date of Assessment Assessment Methodology Overall Compliance Status (select one)

Compliant Non-Compliant Partial Compliance

Summary of Findings Number of Critical/High Findings Remediation Plan and Timeline Evidence Reviewed (summary)

3. Payment Terms

Client will pay Assessor the fees described below in consideration for the assessment and delivery of the Compliance Report.

Assessment Fee (USD) Payment Schedule Late Payment Fee

If payment is not received within the time specified in the Payment Schedule, late fees shall apply as set forth below.

4. Term and Termination

Term Commencement Date Term End Date (if applicable) Termination Notice Period

Either party may terminate this Agreement for material breach if the breach is not cured within the notice period specified above. Termination shall not relieve Client of the obligation to pay fees for services performed prior to termination.

5. Confidentiality

Each party shall maintain in confidence all non-public information disclosed by the other party in connection with this Agreement, including but not limited to cardholder data, assessment results, evidence, and remediation details ("Confidential Information"). Confidential Information shall be used solely for performance or enforcement of this Agreement. Confidentiality obligations do not apply to information that is publicly known through no fault of the receiving party or required to be disclosed by law, provided the disclosing party is given prompt notice and opportunity to seek protective relief.

6. Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the state of without regard to conflicts of law principles.

7. Entire Agreement

This Agreement, together with any appendices or attachments expressly incorporated herein, constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior and contemporaneous agreements, proposals, and communications, whether written or oral.

8. Certifications

Assessor certifies that, to the best of its knowledge, the facts and findings included in the Compliance PCIDSS Report are accurate and based on the assessment procedures performed. Client acknowledges that the Report is based on the environment and evidence available at the time of assessment.

Assessor Certification: Assessor certifies the assessment and report were prepared in accordance with applicable PCI DSS assessment guidance and professional standards.

Client Acknowledgement: Client acknowledges receipt of the Compliance Report and agrees to implement remediation actions as set forth in the Remediation Plan.

Administrative Details

Client Primary Contact Client Address Assessor Organization Assessor Contact

Client:

By:

Date:

Service Provider:

By:

Date:

What the Compliance PCIDSS Report Is and when it applies

The Compliance PCIDSS Report documents an entity's adherence to the Payment Card Industry Data Security Standard (PCI DSS). It consolidates scope definitions, control tests, vulnerability scan results, remediation status, and assessor conclusions into a single compliance record. Organizations that store, process, or transmit cardholder data use this report to demonstrate control effectiveness to acquiring banks, payment processors, and internal stakeholders. Depending on merchant level and service provider classification, the report supports annual on-site assessments, quarterly external scans, and periodic attestations of compliance.

Why maintaining a Compliance PCIDSS Report matters

A clear, complete report reduces audit friction by documenting scope, evidence, test results, and remediation status in one place. It shows payment partners that you have tested technical controls and managed cardholder data risks according to PCI SSC requirements.

Typical owners and recipients of a Compliance PCIDSS Report

Several internal and external roles rely on the Compliance PCIDSS Report for risk management and contractual compliance.

Security and IT teams responsible for implementing and validating technical controls across networks and systems.
Compliance officers and legal teams who manage vendor attestations, contractual obligations, and audit responses.
Acquirers, payment processors, and third-party assessors who require evidence of PCI DSS controls and remediation status.

Use a report template that aligns with your merchant or service-provider level and the assessor's reporting requirements to avoid rework.

Core sections included in a professional Compliance PCIDSS Report

A professional report organizes evidence and findings so an assessor or stakeholder can verify compliance quickly. Standard sections reduce ambiguity and speed review cycles.

Executive summary

High-level assessment conclusion, scope summary, and assessor statement of compliance or non-compliance.

Scope definition

Inventory of in-scope systems, cardholder data flows, segmentation controls, and excluded assets.

Control testing

Results for each PCI DSS requirement, test procedures performed, and pass/fail status.

Vulnerability scans

External scan reports, dates, and remediation status for high/critical findings.

Remediation log

Detailed fixes, responsible owners, target and completion dates, and verification evidence.

Attestation and signatures

Assessor attestation, dates, and authorized signatures or e-signature evidence for acceptance.

Essential data elements to include

Assessed entity: Legal name and DBA

Assessment period: Start and end dates

Assessment scope: In-scope systems listed

Assessor identity: Qualified assessor name

Evidence references: Scan IDs and logs

Signature block: Signed and dated

Step-by-step: preparing and finalizing your Compliance PCIDSS Report

Follow these sequential steps to assemble evidence, document findings, and obtain attestations required by payment partners.

01

Gather evidence: Collect logs, configuration files, and scan reports covering the assessment period.
02

Define scope: Confirm in-scope assets and network segments with system owners before testing.
03

Execute tests: Run control tests and external scans; document procedures and outcomes.
04

Finalize report: Compile sections, attach evidence, and obtain required signatures or attestations.

How to configure an online workflow for the report

Use an eSubmission workflow to collect authorizations, attach evidence, and preserve an audit trail. Configure these settings to match your internal review processes.

Field	Configuration
Signature authentication	Require email + SMS code or SSO for authorized signers
Audit retention	Set audit trail retention to match internal and regulatory requirements
Evidence attachments	Allow PDF, DOCX, CSV and embed scan IDs for traceability
Integration	Map completed reports to ticketing or GRC systems for tracking

Digital signing and technical requirements for eSubmission

Secure eSubmission requires a platform that preserves audit trails, supports required file formats, and integrates with your systems.

Integrations: Salesforce, NetSuite, Google Workspace
File formats: PDF, DOCX, HTML, Excel
Security: TLS 1.2/1.3 and AES-256 at rest

Ensure the chosen platform can produce a verifiable certificate of completion, preserve attachments, and support the signer authentication level needed by your acquirer or assessor.

Typical eSubmission flow for the Compliance PCIDSS Report

A standard online workflow reduces manual handoffs and records every action for later verification.

Upload report: Sender uploads the report and attaches evidence files.
Place fields: Add signature, date, and checkbox fields for attestations.
Signer authentication: Signers verify identity by email, SMS code, or SSO.
Finalize record: System timestamps signature and issues a certificate of completion.

Common PCI DSS reporting and scanning cadence

PCI DSS compliance involves recurring assessment and scanning tasks; align your reporting schedule with merchant level and service agreements.

Annual assessment:

On-site or remote assessment annually for Level 1 merchants and many service providers.

Quarterly scanning:

External vulnerability scans required at least every 90 days and after changes.

Post-remediation validation:

Rescan or retest after high/critical fixes to confirm remediation.

Interim reviews:

Perform configuration reviews after major infrastructure changes.

Submission to acquirer:

Provide the report per contractual timing agreed with your acquiring bank.

Key milestones from assessment start to attestation

Track these numbered stages to keep the assessment on schedule and to document proof points for each milestone.

01

Plan assessment

Define scope, objectives, and timeline with stakeholders and assessor.

02

Collect evidence

Gather logs, configs, and scan outputs covering the assessment period.

03

Test and scan

Perform control tests and external scans per PCI SSC guidance.

04

Remediate issues

Apply fixes, document changes, and schedule validation scans.

Common mistakes organizations make when assembling the report

Inaccurate scope listings that omit systems handling cardholder data, causing scope expansion and rework.
Missing or unlabeled evidence files that force assessors to request additional documentation and delay completion.
Using inconsistent date formats or ambiguous time ranges that prevent correlating logs and scan results.
Weak signer authentication or unsigned attestations that acquirers may reject as incomplete.

Risks and consequences of an incorrect or incomplete report

Acquirer rejection: Delays in merchant onboarding or suspension of card acceptance

Fines and fees: Potential fines by payment brands for non-compliance

Increased liability: Greater exposure in the event of a breach

Contract breaches: Supplier or processor penalties under contracts

Reputational harm: Customer trust and partner relationships impacted

Remediation costs: Higher expense to remediate untested systems

Representative eSignature vendor pricing and capabilities for report workflows

Basic pricing and feature signals to consider when selecting an eSignature vendor for Compliance PCIDSS Report workflows. Confirm plan details with each vendor before procurement.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies by vendor	Varies by vendor	Varies by vendor	Varies by vendor
Bulk Send	Yes	Yes	Yes	Yes	Yes
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Real-world examples of digital report workflows

Practitioners use eSignature and workflow platforms to reduce turnaround and preserve evidence during the assessment lifecycle.

Optica Ventures

Optica adopted digital report templates to standardize evidence collection

The assessor received complete scans and logs in one submission
As a result, assessor follow-up requests dropped significantly and internal review cycles shortened, improving audit readiness.

Martin Properties

Martin Properties moved to online attestations for payment device inventories

Signers authenticated via mobile and desktop
The firm reported consistent signature capture, preserved audit trails, and faster submission to its acquirer.

Practical tips to improve accuracy and reduce review cycles

Small changes in preparation and presentation materially reduce assessor questions and delays.

Standardize file names

Use a consistent naming convention that includes report ID, evidence type, and date so assessors can cross-reference items quickly and avoid misfiled attachments.

Pre-validate scans

Run external ASV scans and internal vulnerability scans before the assessment to correct critical findings and avoid last-minute remediation.

Use clear scope maps

Provide diagrams of cardholder data flows and segmentation controls so assessors can confirm in-scope systems without requesting network inventories.

Preserve audit trails

Capture signer identity, timestamp, IP address, and evidence hashes; maintain these records for the full retention period required by contract or regulation.

Frequently asked questions about the Compliance PCIDSS Report

Answers to common questions about scope, signature validity, evidence, and submission logistics for PCI DSS reporting.

Need help? Contact support

Who can sign the attestation?
An authorized officer or designated security/compliance owner should sign the attestation. The signer must have authority to commit the organization and should be identified by name, title, and authorization method in the report.
Are eSignatures valid for this report?
Yes. Electronic signatures are legally recognized under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, provided intent, consent, attribution, and record retention are satisfied.
Which evidence files are essential?
Include configuration snapshots, vulnerability scan reports with scan IDs, firewall rules, segmentation proof, and remediation logs. Explicitly reference each file in the control-testing section to simplify review.
Can I submit scanned PDFs?
Yes. Scanned PDFs are acceptable if they are legible and accompanied by metadata (creation date, source). Native export formats from scanning tools are preferred when available.
What level of signer authentication is recommended?
Use an authentication method that matches your acquirer’s expectations—email+SMS code, SSO, or stronger identity proofing for critical attestations reduce rejection risk.
How do I handle remediation after the report?
Document remediation steps, assign owners and deadlines, and include verification evidence (re-scans, configuration changes) in a post-assessment addendum to the report.

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