To maintain ongoing PCI compliance, completion of this form is required to enroll in Aperia. This enrollment ensures data integrity and supports adherence to regulatory standards.

Upon validation and enrollment, the corresponding fee will be applied to your monthly invoice. 

• Aperia PCI Enrolment

Please complete all applicable fields accurately to initiate the setup process. Note that a $29.99 non-compliance fee may be assessed for failure to maintain PCI compliance.