Company:
Address
City, State, Zip:
Phone:
To CyberSource Corporation:
I, Name, as the Title of VP or higher of Company Name (“Company”) and a duly authorized
officer, owner, or principal of Company do hereby request CyberSource to configure the
Company’s account to permit the retrieval of certain data related to Company’s subscription
activity and move the data from and to the following Merchant IDs:
Extract data from: Merchant ID
Move to:
Merchant ID
Company agrees to defend, indemnify, and save fully harmless CyberSource Corporation and its
officers, directors, employees, agents, and representatives (collectively the “Indemnified Parties”)
from and against any loss, damages, claims, or expenses of any kind whatsoever, including court
costs and attorney fees, incurred or sustained by the Indemnified Parties with respect to the
services provided by CyberSource Corporation to Company hereunder.
AGREED AND UNDERSTOOD:
By:
Name:
Title:
Date:
30Aug2012