Fillable PCI Self-Assessment Questionnaire B-IP and Attestation of Compliance 2017

Fill Online, Printable, Fillable, Blank PCI Self-Assessment Questionnaire B-IP and Attestation of Compliance 2017 Form

Use Fill to complete blank online LOUISIANA STATE UNIVERSITY pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

PCI Self-Assessment Questionnaire B-IP and Attestation of Compliance 2017

On average this form takes 84 minutes to complete

The PCI Self-Assessment Questionnaire B-IP and Attestation of Compliance 2017 form is 57 pages long and contains:

0 signatures
404 check-boxes
148 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Louisiana State University

BROWSE LOUISIANA STATE UNIVERSITY FORMS

Related forms

PCI-DSS-v3 2-SAQ-A-rev1 1
PCI Self-Assessment Questionnaire B Attestation of Compliance 2017
PCI-DSS-v3 2-SAQ-A EP-rev1 1
Payment Card Industry Self-Assessment Questionnaire C and Attestation of Compliance 2017
MerchantInformationQuestionnaire
PCI-DSS-v3 2-SAQ-C VT-rev1 1
Defermentrequesteuetoeconomichardship L O U I S I A N A S T A T E U N I V E R S I T Y
PCI-DSS-v3 2-SAQ-D Merchant-rev1 1
Defermentrequestduetounemployment L O U I S I A N A S T A T E U N I V E R S I T Y
PCI-DSS-v3 2-SAQ-P2PE-rev1 1
Defermentrequestduetostudentenrollment
Activemilitarydeferment Military Service and Post-Active Duty Student Deferment Request
Defermentrequestduetoemployment
Applicationforforbearance L O U I S I A N A S T A T E U N I V E R S I T Y
Cancellationrequestduetoemployment
Applicationforspecialpaymentarrangement
Cancellationform (Louisiana State University)
Cancellation Request Dueto Employment (Louisiana State University)
DefermentRequestDuetoEconomicHardship L O U I S I A N A S T A T E U N I V E R S I T Y
Deferment Request Dueto Employment (Louisiana State University)

Fill has a huge library of thousands of forms all set up to be filled in easily and signed.

Fill in your chosen form

Sign the form using our drawing tool

Send to someone else to fill in and sign.

find another form

Redo

Arial Font

Arial
Calibri
Roboto
Open Sans

AFont color

AB
A.B
A..B
A...B
A....B

Remove Field

ADD FIELDS

Payment Card Industry (PCI)

Data Security Standard

Self-Assessment Questionnaire B-IP

and Attestation of Compliance

Merchants with Standalone, IP-Connected

PTS Point-of-Interaction (POI) Terminals –

No Electronic Cardholder Data Storage

For use with PCI DSS Version 3.2

Version 1.1

January 2017

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 January 2017

Document Changes

Date

PCI DSS

Version

SAQ

Revision

Description

N/A

1.0

Not used.

N/A

2.0

Not used.

February 2014

3.0

New SAQ to address requirements applicable to merchants

who process cardholder data only via standalone, PTS-

approved point-of-interaction devices with an IP connection

to the payment processor.

Content aligns with PCI DSS v3.0 requirements and testing

procedures.

April 2015

3.1

Updated to align with PCI DSS v3.1. For details of PCI

DSS changes, see PCI DSS – Summary of Changes from

PCI DSS Version 3.0 to 3.1.

July 2015

3.1

1.1

Updated to remove references to “best practices” prior to

June 30, 2015.

April 2016

3.2

1.0

Updated to align with PCI DSS v3.2. For details of PCI

DSS changes, see PCI DSS – Summary of Changes from

PCI DSS Version 3.1 to 3.2.

Requirements added from PCI DSS v3.2 Appendix A2.

January 2017

3.2

1.1

Updated Document Changes to clarify requirements added

in the April 2016 update.

Updated Before You Begin section to clarify term “SCR”

and intent of permitted systems.

Added Requirement 8.3.1 to align with intent of

Requirement 2.3.

Added Requirement 11.3.4 to verify segmentation controls,

if segmentation is used.

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 January 2017

Table of Contents

Document Changes .................................................................................................................. i

Before You Begin .....................................................................................................................iii

PCI DSS Self-Assessment Completion Steps ...................................................................................... iii

Understanding the Self-Assessment Questionnaire ........................................................................... iv

Expected Testing ................................................................................................................................... iv

Completing the Self-Assessment Questionnaire .................................................................................. v

Guidance for Non-Applicability of Certain, Specific Requirements .................................................... v

Legal Exception .................................................................................................................................... v

Section 1: Assessment Information ..................................................................................... 1

Section 2: Self-Assessment Questionnaire B-IP ................................................................. 4

Build and Maintain a Secure Network .................................................................................................... 4

Requirement 1: Install and maintain a firewall configuration to protect data ........................................ 4

Requirement 2: Do not use vendor-supplied defaults for system passwords and other security

parameters .................................................................................................................. 7

Protect Cardholder Data .......................................................................................................................... 9

Requirement 3: Protect stored cardholder data.................................................................................... 9

Requirement 4: Encrypt transmission of cardholder data across open, public networks ................... 11

Maintain a Vulnerability Management Program .................................................................................. 13

Requirement 6: Develop and maintain secure systems and applications .......................................... 13

Implement Strong Access Control Measures ...................................................................................... 15

Requirement 7: Restrict access to cardholder data by business need to know ................................. 15

Requirement 8: Identify and authenticate access to system components ......................................... 16

Requirement 9: Restrict physical access to cardholder data ............................................................. 17

Regularly Monitor and Test Networks .................................................................................................. 22

Requirement 11: Regularly test security systems and processes ........................................................ 22

Maintain an Information Security Policy .............................................................................................. 24

Requirement 12: Maintain a policy that addresses information security for all personnel ................... 24

Appendix A: Additional PCI DSS Requirements ........................................................................ 27

Appendix A1: Additional PCI DSS Requirements for Shared Hosting Providers ............................ 27

Appendix A2: Additional PCI DSS Requirements for Entities using SSL/early TLS ...................... 27

Appendix A3: Designated Entities Supplemental Validation (DESV) .............................................. 28

Appendix B: Compensating Controls Worksheet ...................................................................... 29

Appendix C: Explanation of Non-Applicability........................................................................... 30

Section 3: Validation and Attestation Details .....................................................................31

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 January 2017

Before You Begin

SAQ B-IP has been developed to address requirements applicable to merchants who process cardholder

data only via standalone, PTS-approved point-of-interaction (POI) devices with an IP connection to the

payment processor. An exception applies for POI devices classified as Secure Card Readers (SCR);

merchants using SCRs are not eligible for this SAQ.

SAQ B-IP merchants may be either brick-and-mortar (card-present) or mail/telephone-order (card-not-

present) merchants, and do not store cardholder data on any computer system.

SAQ B-IP merchants confirm that, for this payment channel:

 Your company uses only standalone, PTS-approved point-of-interaction (POI) devices (excludes

SCRs) connected via IP to your payment processor to take your customers’ payment card

information;

 The standalone IP-connected POI devices are validated to the PTS POI program as listed on the

PCI SSC website (excludes SCRs);

 The standalone IP-connected POI devices are not connected to any other systems within your

environment (this can be achieved via network segmentation to isolate POI devices from other

systems)

;

 The only transmission of cardholder data is from the PTS-approved POI devices to the payment

processor;

 The POI device does not rely on any other device (e.g., computer, mobile phone, tablet, etc.) to

connect to the payment processor;

 Any cardholder data your company retains is on paper (for example, printed reports or receipts),

and these documents are not received electronically; and

 Your company does not store cardholder data in electronic format.

This SAQ is not applicable to e-commerce channels.

This shortened version of the SAQ includes questions that apply to a specific type of small merchant

environment, as defined in the above eligibility criteria. If there are PCI DSS requirements applicable to

your environment that are not covered in this SAQ, it may be an indication that this SAQ is not suitable for

your environment. Additionally, you must still comply with all applicable PCI DSS requirements in order to

be PCI DSS compliant.

PCI DSS Self-Assessment Completion Steps

1. Identify the applicable SAQ for your environment – refer to the Self-Assessment Questionnaire

Instructions and Guidelines document on PCI SSC website for information.

2. Confirm that your environment is properly scoped and meets the eligibility criteria for the SAQ you

are using (as defined in Part 2g of the Attestation of Compliance).

3. Assess your environment for compliance with applicable PCI DSS requirements.

4. Complete all sections of this document:

This criteria is not intended to prohibit more than one of the permitted system type (that is, IP-connected POI

devices) being on the same network zone, as long as the permitted systems are isolated from other types of systems

(e.g. by implementing network segmentation). Additionally, this criteria is not intended to prevent the defined system

type from being able to transmit transaction information to a third party for processing, such as an acquirer or

payment processor, over a network.

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 January 2017

 Section 1 (Parts 1 & 2 of the AOC) – Assessment Information and Executive Summary.

 Section 2 – PCI DSS Self-Assessment Questionnaire (SAQ B-IP)

 Section 3 (Parts 3 & 4 of the AOC) – Validation and Attestation Details and Action Plan for

Non-Compliant Requirements (if applicable)

5. Submit the SAQ and Attestation of Compliance (AOC), along with any other requested

documentation—such as ASV scan reports—to your acquirer, payment brand or other requester.

Understanding the Self-Assessment Questionnaire

The questions contained in the “PCI DSS Question” column in this self-assessment questionnaire are

based on the requirements in the PCI DSS.

Additional resources that provide guidance on PCI DSS requirements and how to complete the self-

assessment questionnaire have been provided to assist with the assessment process. An overview of

some of these resources is provided below:

Document

Includes:

PCI DSS

(PCI Data Security Standard

Requirements and Security Assessment

Procedures)

 Guidance on Scoping

 Guidance on the intent of all PCI DSS Requirements

 Details of testing procedures

 Guidance on Compensating Controls

SAQ Instructions and Guidelines

documents

 Information about all SAQs and their eligibility criteria

 How to determine which SAQ is right for your

organization

PCI DSS and PA-DSS Glossary of

Terms, Abbreviations, and Acronyms

 Descriptions and definitions of terms used in the PCI

DSS and self-assessment questionnaires

These and other resources can be found on the PCI SSC website (www.pcisecuritystandards.org).

Organizations are encouraged to review the PCI DSS and other supporting documents before beginning

an assessment.

Expected Testing

The instructions provided in the “Expected Testing” column are based on the testing procedures in the

PCI DSS, and provide a high-level description of the types of testing activities that should be performed in

order to verify that a requirement has been met. Full details of testing procedures for each requirement

can be found in the PCI DSS.

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 January 2017

Completing the Self-Assessment Questionnaire

For each question, there is a choice of responses to indicate your company’s status regarding that

requirement. Only one response should be selected for each question.

A description of the meaning for each response is provided in the table below:

Response

When to use this response:

Yes

The expected testing has been performed, and all elements of the requirement

have been met as stated.

Yes with CCW

(Compensating

Control Worksheet)

The expected testing has been performed, and the requirement has been met

with the assistance of a compensating control.

All responses in this column require completion of a Compensating Control

Worksheet (CCW) in Appendix B of the SAQ.

Information on the use of compensating controls and guidance on how to

complete the worksheet is provided in the PCI DSS.

Some or all elements of the requirement have not been met, or are in the

process of being implemented, or require further testing before it will be known

if they are in place.

N/A

(Not Applicable)

The requirement does not apply to the organization’s environment. (See

Guidance for Non-Applicability of Certain, Specific Requirements below for

examples.)

All responses in this column require a supporting explanation in Appendix C of

the SAQ.

Guidance for Non-Applicability of Certain, Specific Requirements

While many organizations completing SAQ B-IP will need to validate compliance with every PCI DSS

requirement in this SAQ, some organizations with very specific business models may find that some

requirements do not apply. For example, a company that does not use wireless technology in any

capacity would not be expected to validate compliance with the sections of PCI DSS that are specific to

managing wireless technology (for example, Requirements 1.2.3, 2.1.1, and 4.1.1).

If any requirements are deemed not applicable to your environment, select the “N/A” option for that

specific requirement, and complete the “Explanation of Non-Applicability” worksheet in Appendix C for

each “N/A” entry.

Legal Exception

If your organization is subject to a legal restriction that prevents the organization from meeting a PCI DSS

requirement, check the “No” column for that requirement and complete the relevant attestation in Part 3.

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 1: Assessment Information January 2017

Section 1: Assessment Information

Instructions for Submission

This document must be completed as a declaration of the results of the merchant’s self-assessment with the

Payment Card Industry Data Security Standard Requirements and Security Assessment Procedures (PCI

DSS). Complete all sections: The merchant is responsible for ensuring that each section is completed by the

relevant parties, as applicable. Contact acquirer (merchant bank) or the payment brands to determine reporting

and submission procedures.

Part 1. Merchant and Qualified Security Assessor Information

Part 1a. Merchant Organization Information

Company Name:

DBA (doing

business as):

Contact Name:

Title:

Telephone:

E-mail:

Business Address:

City:

State/Province:

Country:

Zip:

URL:

Part 1b. Qualified Security Assessor Company Information (if applicable)

Company Name:

Lead QSA Contact Name:

Title:

Telephone:

E-mail:

Business Address:

City:

State/Province:

Country:

Zip:

URL:

Part 2. Executive Summary

Part 2a. Type of Merchant Business (check all that apply)

Retailer Telecommunication Grocery and Supermarkets

Petroleum E-Commerce Mail order/telephone order (MOTO)

Others (please specify):

What types of payment channels does your business

serve?

Mail order/telephone order (MOTO)

E-Commerce

Card-present (face-to-face)

Which payment channels are covered by this SAQ?

Mail order/telephone order (MOTO)

E-Commerce

Card-present (face-to-face)

Note: If your organization has a payment channel or process that is not covered by this SAQ, consult your

acquirer or payment brand about validation for the other channels.

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 1: Assessment Information January 2017

Part 2b. Description of Payment Card Business

How and in what capacity does your business

store, process and/or transmit cardholder data?

Part 2c. Locations

List types of facilities and a summary of locations (for example, retail outlets, corporate offices, data centers,

call centers, etc.) included in the PCI DSS review.

Type of facility

Number of facilities

of this type

Location(s) of facility (e.g. city, country)

Example: Retail outlets

Boston, MA, USA

Part 2d. Payment Application

Does the organization use one or more Payment Applications? Yes No

Provide 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)

Yes No

Part 2e. Description of Environment

Provide a high-level description of the environment covered by

this assessment.

For example:

• Connections into and out of the cardholder data environment

(CDE).

• Critical system components within the CDE, such as POS

devices, databases, web servers, etc., and any other

necessary payment components, as applicable.

Does your business use network segmentation to affect the scope of your PCI DSS

environment?

(Refer to “Network Segmentation” section of PCI DSS for guidance on network

segmentation)

Yes No

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 1: Assessment Information January 2017

Part 2f. Third-Party Service Providers

Does your company use a Qualified Integrator & Reseller (QIR)?

If Yes:

Name of QIR Company:

QIR Individual Name:

Description of services provided by QIR:

Yes No

Does your company share cardholder data with any third-party service providers (for

example, Qualified Integrator & Resellers (QIR), gateways, payment processors, payment

service providers (PSP), web-hosting companies, airline booking agents, loyalty program

agents, etc.)?

Yes No

If Yes:

Name of service provider:

Description of services provided:

Note: Requirement 12.8 applies to all entities in this list.

Part 2g. Eligibility to Complete SAQ B-IP

Merchant certifies eligibility to complete this shortened version of the Self-Assessment Questionnaire

because, for this payment channel:

Merchant uses only standalone, PTS-approved point-of-interaction (POI) devices (excludes SCRs)

connected via IP to merchant’s payment processor to take customers’ payment card information;

The standalone IP-connected POI devices are validated to the PTS POI program as listed on the PCI

SSC website (excludes SCRs);

The standalone IP-connected POI devices are not connected to any other systems within the

merchant environment (this can be achieved via network segmentation to isolate POI devices from

other systems);

The only transmission of cardholder data is from the PTS-approved POI devices to the payment

processor;

The POI device does not rely on any other device (e.g., computer, mobile phone, tablet, etc.) to

connect to the payment processor;

Merchant does not store cardholder data in electronic format ; and

If Merchant does store cardholder data, such data is only paper reports or copies of paper receipts

and is not received electronically.

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

Section 2: Self-Assessment Questionnaire B-IP

Note: The following questions are numbered according to PCI DSS requirements and testing procedures, as defined in the PCI DSS

Requirements and Security Assessment Procedures document.

Self-assessment completion date:

Build and Maintain a Secure Network

Requirement 1: Install and maintain a firewall configuration to protect data

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

Yes with

CCW

N/A

1.1.2

(a) Is there a current network diagram that

documents all connections between the

cardholder data environment and other networks,

including any wireless networks?

 Review current network diagram

 Examine network configurations

(b) Is there a process to ensure the diagram is kept

current?

 Interview responsible personnel

1.1.4

(a) Is a firewall required and implemented at each

Internet connection and between any

demilitarized zone (DMZ) and the internal network

zone?

 Review firewall configuration standards

 Observe network configurations to verify

that a firewall(s) is in place

(b) Is the current network diagram consistent with the

firewall configuration standards?

 Compare firewall configuration standards

to current network diagram

1.1.6

(a) Do firewall and router configuration standards

include a documented list of services, protocols,

and ports, including business justification and

approval for each?

 Review firewall and router configuration

standards

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

Yes with

CCW

N/A

(b) Are all insecure services, protocols, and ports

identified, and are security features documented

and implemented for each identified service?

 Review firewall and router configuration

standards

 Examine firewall and router configurations

1.2

Do firewall and router configurations restrict

connections between untrusted networks and any

system in the cardholder data environment as follows:

Note: An “untrusted network” is any network that is

external to the networks belonging to the entity under

review, and/or which is out of the entity’s ability to

control or manage.

1.2.1

(a) Is inbound and outbound traffic restricted to that

which is necessary for the cardholder data

environment?

 Review firewall and router configuration

standards

 Examine firewall and router configurations

(b) Is all other inbound and outbound traffic

specifically denied (for example by using an

explicit “deny all” or an implicit deny after allow

statement)?

 Review firewall and router configuration

standards

 Examine firewall and router configurations

1.2.3

Are perimeter firewalls installed between all wireless

networks and the cardholder data environment, and

are these firewalls configured to deny or, if traffic is

necessary for business purposes, permit only

authorized traffic between the wireless environment

and the cardholder data environment?

 Review firewall and router configuration

standards

 Examine firewall and router configurations

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

Yes with

CCW

N/A

1.3

Is direct public access prohibited between the Internet

and any system component in the cardholder data

environment, as follows:

1.3.3

Are anti-spoofing measures implemented to detect

and block forged sourced IP addresses from entering

the network?

(For example, block traffic originating from the internet

with an internal address)

 Examine firewall and router configurations

1.3.4

Is outbound traffic from the cardholder data

environment to the Internet explicitly authorized?

 Examine firewall and router configurations

1.3.5

Are only established connections permitted into the

network?

 Examine firewall and router configurations

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

Requirement 2: Do not use vendor-supplied defaults for system passwords and other security parameters

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

Yes with

CCW

N/A

2.1

(a) Are vendor-supplied defaults always changed

before installing a system on the network?

This applies to ALL default passwords, including but not

limited to those used by operating systems, software that

provides security services, application and system

accounts, point-of-sale (POS) terminals, payment

applications, Simple Network Management Protocol

(SNMP) community strings, etc.).

 Review policies and procedures

 Examine vendor documentation

 Observe system configurations and

account settings

 Interview personnel

(b) Are unnecessary default accounts removed or

disabled before installing a system on the network?

 Review policies and procedures

 Review vendor documentation

 Examine system configurations and

account settings

 Interview personnel

2.1.1

For wireless environments connected to the cardholder

data environment or transmitting cardholder data, are

ALL wireless vendor defaults changed at installations, as

follows:

(a) Are encryption keys changed from default at

installation, and changed anytime anyone with

knowledge of the keys leaves the company or

changes positions?

 Review policies and procedures

 Review vendor documentation

 Interview personnel

(b) Are default SNMP community strings on wireless

devices changed at installation?

 Review policies and procedures

 Review vendor documentation

 Interview personnel

 Examine system configurations

points changed at installation?

 Review policies and procedures

 Interview personnel

 Examine system configurations

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

Yes with

CCW

N/A

(d) Is firmware on wireless devices updated to support

strong encryption for authentication and transmission

over wireless networks?

 Review policies and procedures

 Review vendor documentation

 Examine system configurations

(e) Are other security-related wireless vendor defaults

changed, if applicable?

 Review policies and procedures

 Review vendor documentation

 Examine system configurations

2.3

Is non-console administrative access, including web-

based access, encrypted as follows:

Note: Where SSL/early TLS is used, the requirements in

Appendix A2 must be completed.

(a) Is all non-console administrative access encrypted

with strong cryptography, and is a strong encryption

method invoked before the administrator’s

password is requested?

 Examine system components

 Examine system configurations

 Observe an administrator log on

(b) Are system services and parameter files configured

to prevent the use of Telnet and other insecure

remote login commands?

 Examine system components

 Examine services and files

interfaces encrypted with strong cryptography?

 Examine system components

 Observe an administrator log on

(d) For the technology in use, is strong cryptography

implemented according to industry best practice

and/or vendor recommendations?

 Examine system components

 Review vendor documentation

 Interview personnel

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

Protect Cardholder Data

Requirement 3: Protect stored cardholder data

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

Yes with

CCW

N/A

3.2

rendered unrecoverable upon completion of the

authorization process?

 Review policies and procedures

 Examine system configurations

 Examine deletion processes

(d) Do all systems adhere to the following

requirements regarding non-storage of sensitive

authentication data after authorization (even if

encrypted):

3.2.1

The full contents of any track (from the magnetic

stripe located on the back of a card, equivalent data

contained on a chip, or elsewhere) are not stored

after authorization?

This data is alternatively called full track, track, track

1, track 2, and magnetic-stripe data.

Note: In the normal course of business, the following

data elements from the magnetic stripe may need to

be retained:

 The cardholder’s name,

 Primary account number (PAN),

 Expiration date, and

 Service code

To minimize risk, store only these data elements as

needed for business.

 Examine data sources including:

 Incoming transaction data

 All logs

 History files

 Trace files

 Database schema

 Database contents

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

Yes with

CCW

N/A

3.2.2

The card verification code or value (three-digit or

four-digit number printed on the front or back of a

payment card) is not stored after authorization?

 Examine data sources including:

 Incoming transaction data

 All logs

 History files

 Trace files

 Database schema

 Database contents

3.2.3

The personal identification number (PIN) or the

encrypted PIN block is not stored after authorization?

 Examine data sources including:

 Incoming transaction data

 All logs

 History files

 Trace files

 Database schema

 Database contents

3.3

Is the PAN masked when displayed (the first six and

last four digits are the maximum number of digits to

be displayed) such that only personnel with a

legitimate business need can see more than the first

six/last four digits of the PAN?

Note: This requirement does not supersede stricter

requirements in place for displays of cardholder

data—for example, legal or payment card brand

requirements for point-of-sale (POS) receipts.

 Review policies and procedures

 Review roles that need access to displays

of full PAN

 Examine system configurations

 Observe displays of PAN

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

Requirement 4: Encrypt transmission of cardholder data across open, public networks

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

Yes with

CCW

N/A

4.1

(a) Are strong cryptography and security protocols used

to safeguard sensitive cardholder data during

transmission over open, public networks?

Note: Where SSL/early TLS is used, the requirements in

Appendix A2 must be completed.

Examples of open, public networks include but are not

limited to the Internet; wireless technologies, including

802.11 and Bluetooth; cellular technologies, for example,

Global System for Mobile communications (GSM), Code

division multiple access (CDMA); and General Packet

Radio Service (GPRS).

 Review documented standards

 Review policies and procedures

 Review all locations where CHD is

transmitted or received

 Examine system configurations

(b) Are only trusted keys and/or certificates accepted?

 Observe inbound and outbound

transmissions

 Examine keys and certificates

secure configurations, and to not support insecure

versions or configurations?

 Examine system configurations

(d) Is the proper encryption strength implemented for

the encryption methodology in use (check vendor

recommendations/best practices)?

 Review vendor documentation

 Examine system configurations

(e) For TLS implementations, is TLS enabled whenever

cardholder data is transmitted or received?

For example, for browser-based implementations:

 “HTTPS” appears as the browser Universal Record

Locator (URL) protocol, and

 Cardholder data is only requested if “HTTPS”

appears as part of the URL.

 Examine system configurations

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

Yes with

CCW

N/A

4.1.1

Are industry best practices used to implement strong

encryption for authentication and transmission for

wireless networks transmitting cardholder data or

connected to the cardholder data environment?

 Review documented standards

 Review wireless networks

 Examine system configuration settings

4.2

(b) Are policies in place that state that unprotected

PANs are not to be sent via end-user messaging

technologies?

 Review policies and procedures

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

Maintain a Vulnerability Management Program

Requirement 6: Develop and maintain secure systems and applications

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

with

CCW

N/A

6.1

Is there a process to identify security vulnerabilities,

including the following:

 Using reputable outside sources for vulnerability

information?

 Assigning a risk ranking to vulnerabilities that includes

identification of all “high” risk and “critical”

vulnerabilities?

Note: Risk rankings should be based on industry best

practices as well as consideration of potential impact. For

example, criteria for ranking vulnerabilities may include

consideration of the CVSS base score and/or the

classification by the vendor, and/or type of systems

affected.

Methods for evaluating vulnerabilities and assigning risk

ratings will vary based on an organization’s environment

and risk assessment strategy. Risk rankings should, at a

minimum, identify all vulnerabilities considered to be a

“high risk” to the environment. In addition to the risk

ranking, vulnerabilities may be considered “critical” if they

pose an imminent threat to the environment, impact critical

systems, and/or would result in a potential compromise if

not addressed. Examples of critical systems may include

security systems, public-facing devices and systems,

databases, and other systems that store, process or

transmit cardholder data.

 Review policies and procedures

 Interview personnel

 Observe processes

6.2

(a) Are all system components and software protected

from known vulnerabilities by installing applicable

vendor-supplied security patches?

 Review policies and procedures

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

with

CCW

N/A

(b) Are critical security patches installed within one month

of release?

Note: Critical security patches should be identified

according to the risk ranking process defined in

Requirement 6.1.

 Review policies and procedures

 Examine system components

 Compare list of security patches

installed to recent vendor patch lists

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

Implement Strong Access Control Measures

Requirement 7: Restrict access to cardholder data by business need to know

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

Yes with

CCW

N/A

7.1

Is access to system components and cardholder data

limited to only those individuals whose jobs require

such access, as follows:

7.1.2

Is access to privileged user IDs restricted as follows:

 To least privileges necessary to perform job

responsibilities?

 Assigned only to roles that specifically require that

privileged access?

 Examine written access control policy

 Interview personnel

 Interview management

 Review privileged user IDs

7.1.3

Is access assigned based on individual personnel’s

job classification and function?

 Examine written access control policy

 Interview management

 Review user IDs

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

Requirement 8: Identify and authenticate access to system components

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

with

CCW

N/A

8.1.5

(a) Are accounts used by third parties to access,

support, or maintain system components via

remote access enabled only during the time period

needed and disabled when not in use?

 Review password procedures

 Interview personnel

 Observe processes

(b) Are third party remote access accounts monitored

when in use?

 Interview personnel

 Observe processes

8.3

Is all individual non-console administrative access and

all remote access to the CDE secured using multi-

factor authentication, as follows:

Note: Multi-factor authentication requires that a

minimum of two of the three authentication methods

(see PCI DSS Requirement 8.2 for descriptions of

authentication methods) be used for authentication.

Using one factor twice (for example, using two

separate passwords) is not considered multi-factor

authentication.

8.3.1

Is multi-factor authentication incorporated for all non-

console access into the CDE for personnel with

administrative access?

Note: This requirement is a best practice until January

31, 2018, after which it becomes a requirement.

 Examine system configurations

 Observe administrator logging into

CDE

8.3.2

Is multi-factor authentication incorporated for all remote

network access (both user and administrator, and

including third party access for support and

maintenance) originating from outside the entity’s

network?

 Examine system configurations

 Observe personnel connecting

remotely

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

with

CCW

N/A

8.5

Are group, shared, or generic accounts, passwords, or

other authentication methods prohibited as follows:

 Generic user IDs and accounts are disabled or

removed;

 Shared user IDs for system administration activities

and other critical functions do not exist; and

 Shared and generic user IDs are not used to

administer any system components

 Review policies and procedures

 Examine user ID lists

 Interview personnel

Requirement 9: Restrict physical access to cardholder data

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

with

CCW

N/A

9.1.2

Are physical and/or logical controls in place to restrict

access to publicly accessible network jacks?

For example, network jacks located in public areas and

areas accessible to visitors could be disabled and only

enabled when network access is explicitly authorized.

Alternatively, processes could be implemented to ensure

that visitors are escorted at all times in areas with active

network jacks.

 Review policies and procedures

 Interview personnel

 Observe locations

9.5

Are all media physically secured (including but not

limited to computers, removable electronic media, paper

receipts, paper reports, and faxes)?

For purposes of Requirement 9, “media” refers to all

paper and electronic media containing cardholder data.

 Review policies and procedures for

physically securing media

 Interview personnel

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

with

CCW

N/A

9.6

(a) Is strict control maintained over the internal or

external distribution of any kind of media?

 Review policies and procedures for

distribution of media

(b) Do controls include the following:

9.6.1

Is media classified so the sensitivity of the data can be

determined?

 Review policies and procedures for

media classification

 Interview security personnel

9.6.2

Is media sent by secured courier or other delivery

method that can be accurately tracked?

 Interview personnel

 Examine media distribution tracking

logs and documentation

9.6.3

Is management approval obtained prior to moving the

media (especially when media is distributed to

individuals)?

 Interview personnel

 Examine media distribution tracking

logs and documentation

9.7

Is strict control maintained over the storage and

accessibility of media?

 Review policies and procedures

9.8

(a) Is all media destroyed when it is no longer needed

for business or legal reasons?

 Review periodic media destruction

policies and procedures

9.8.1

(a) Are hardcopy materials cross-cut shredded,

incinerated, or pulped so that cardholder data cannot

be reconstructed?

 Review periodic media destruction

policies and procedures

 Interview personnel

 Observe processes

(b) Are storage containers used for materials that

contain information to be destroyed secured to

prevent access to the contents?

 Examine security of storage

containers

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

with

CCW

N/A

9.9

Are devices that capture payment card data via direct

physical interaction with the card protected against

tampering and substitution as follows?

Note: This requirement applies to card-reading devices

used in card-present transactions (that is, card swipe or

dip) at the point of sale. This requirement is not intended

to apply to manual key-entry components such as

computer keyboards and POS keypads.

(a) Do policies and procedures require that a list of such

devices be maintained?

 Review policies and procedures

(b) Do policies and procedures require that devices are

periodically inspected to look for tampering or

substitution?

 Review policies and procedures

are trained to be aware of suspicious behavior and

to report tampering or substitution of devices?

 Review policies and procedures

9.9.1

(a) Does the list of devices include the following?

 Make, model of device

 Location of device (for example, the address of

the site or facility where the device is located)

 Device serial number or other method of unique

identification

 Examine the list of devices

(b) Is the list accurate and up to date?

 Observe devices and device

locations and compare to list

added, relocated, decommissioned, etc.?

 Interview personnel

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

with

CCW

N/A

9.9.2

(a) Are device surfaces periodically inspected to detect

tampering (for example, addition of card skimmers

to devices), or substitution (for example, by

checking the serial number or other device

characteristics to verify it has not been swapped

with a fraudulent device) as follows?

Note: Examples of signs that a device might have been

tampered with or substituted include unexpected

attachments or cables plugged into the device, missing

or changed security labels, broken or differently colored

casing, or changes to the serial number or other external

markings.

 Interview personnel

 Observe inspection processes and

compare to defined processes

(b) Are personnel aware of procedures for inspecting

devices?

 Interview personnel

9.9.3

Are personnel trained to be aware of attempted

tampering or replacement of devices, to include the

following?

(a) Do training materials for personnel at point-of-sale

locations include the following?

 Verify the identity of any third-party persons

claiming to be repair or maintenance personnel,

prior to granting them access to modify or

troubleshoot devices.

 Do not install, replace, or return devices without

verification.

 Be aware of suspicious behavior around devices

(for example, attempts by unknown persons to

unplug or open devices).

 Report suspicious behavior and indications of

device tampering or substitution to appropriate

personnel (for example, to a manager or security

officer).

 Review training materials

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

with

CCW

N/A

(b) Have personnel at point-of-sale locations received

training, and are they aware of procedures to detect

and report attempted tampering or replacement of

devices?

 Interview personnel at POS locations

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

Regularly Monitor and Test Networks

Requirement 11: Regularly test security systems and processes

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

with

CCW

N/A

11.2.2

(a) Are quarterly external vulnerability scans performed?

Note: Quarterly external vulnerability scans must be

performed by an Approved Scanning Vendor (ASV),

approved by the Payment Card Industry Security

Standards Council (PCI SSC).

Refer to the ASV Program Guide published on the PCI

SSC website for scan customer responsibilities, scan

preparation, etc.

 Review results from the four

most recent quarters of external

vulnerability scans

(b) Do external quarterly scan and rescan results satisfy

the ASV Program Guide requirements for a passing

scan (for example, no vulnerabilities rated 4.0 or higher

by the CVSS, and no automatic failures)?

 Review results of each external

quarterly scan and rescan

a PCI SSC Approved Scanning Vendor (ASV?

 Review results of each external

quarterly scan and rescan

11.3.4

If segmentation is used to isolate the CDE from other

networks:

(a) Are penetration-testing procedures defined to test all

segmentation methods, to confirm they are operational

and effective, and isolate all out-of-scope systems

from systems in the CDE?

 Examine segmentation controls

 Review penetration-testing

methodology

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

with

CCW

N/A

(b) Does penetration testing to verify segmentation

controls meet the following?

 Performed at least annually and after any changes

to segmentation controls/methods

 Covers all segmentation controls/methods in use

 Verifies that segmentation methods are operational

and effective, and isolate all out-of-scope systems

from systems in the CDE.

 Examine results from the most

recent penetration test

qualified external third party, and if applicable, does

organizational independence of the tester exist (not

required to be a QSA or ASV)?

 Interview responsible

personnel

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

Maintain an Information Security Policy

Requirement 12: Maintain a policy that addresses information security for all personnel

Note: For the purposes of Requirement 12, “personnel” refers to full-time part-time employees, temporary employees and personnel, and

contractors and consultants who are “resident” on the entity’s site or otherwise have access to the company’s site cardholder data environment.

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

with

CCW

N/A

12.1

Is a security policy established, published, maintained,

and disseminated to all relevant personnel?

 Review the information security

policy

12.1.1

Is the security policy reviewed at least annually and

updated when the environment changes?

 Review the information security

policy

 Interview responsible personnel

12.3

Are usage policies for critical technologies developed to

define proper use of these technologies and require the

following:

Note: Examples of critical technologies include, but are

not limited to, remote access and wireless technologies,

laptops, tablets, removable electronic media, e-mail

usage and Internet usage.

12.3.1

Explicit approval by authorized parties to use the

technologies?

 Review usage policies

 Interview responsible personnel

12.3.3

A list of all such devices and personnel with access?

 Review usage policies

 Interview responsible personnel

12.3.5

Acceptable uses of the technologies?

 Review usage policies

 Interview responsible personnel

12.3.9

Activation of remote-access technologies for vendors

and business partners only when needed by vendors

and business partners, with immediate deactivation after

use?

 Review usage policies

 Interview responsible personnel

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

with

CCW

N/A

12.4

Do security policy and procedures clearly define

information security responsibilities for all personnel?

 Review information security policy

and procedures

 Interview a sample of responsible

personnel

12.5

(b) Are the following information security management

responsibilities formally assigned to an individual or

team:

12.5.3

Establishing, documenting, and distributing security

incident response and escalation procedures to ensure

timely and effective handling of all situations?

 Review information security policy

and procedures

12.6

(a) Is a formal security awareness program in place to

make all personnel aware of the cardholder data

security policy and procedures?

 Review security awareness program

12.8

Are policies and procedures maintained and

implemented to manage service providers with whom

cardholder data is shared, or that could affect the

security of cardholder data, as follows:

12.8.1

Is a list of service providers maintained, including a

description of the service(s) provided?

 Review policies and procedures

 Observe processes

 Review list of service providers

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

with

CCW

N/A

12.8.2

Is a written agreement maintained that includes an

acknowledgement that the service providers are

responsible for the security of cardholder data the

service providers possess or otherwise store, process,

or transmit on behalf of the customer, or to the extent

that they could impact the security of the customer’s

cardholder data environment?

Note: The exact wording of an acknowledgement will

depend on the agreement between the two parties, the

details of the service being provided, and the

responsibilities assigned to each party. The

acknowledgement does not have to include the exact

wording provided in this requirement.

 Observe written agreements

 Review policies and procedures

12.8.3

Is there an established process for engaging service

providers, including proper due diligence prior to

engagement?

 Observe processes

 Review policies and procedures and

supporting documentation

12.8.4

Is a program maintained to monitor service providers’

PCI DSS compliance status at least annually?

 Observe processes

 Review policies and procedures and

supporting documentation

12.8.5

Is information maintained about which PCI DSS

requirements are managed by each service provider,

and which are managed by the entity?

 Observe processes

 Review policies and procedures and

supporting documentation

12.10.1

(a) Has an incident response plan been created to be

implemented in the event of system breach?

 Review the incident response plan

 Review incident response plan

procedures

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

Appendix A: Additional PCI DSS Requirements

Appendix A1: Additional PCI DSS Requirements for Shared Hosting Providers

This appendix is not used for merchant assessments.

Appendix A2: Additional PCI DSS Requirements for Entities using SSL/early TLS

PCI DSS Question

Expected Testing

Response

(Check one response for each

question)

Yes

Yes with

CCW

N/A

A2.1

For POS POI terminals (and the SSL/TLS termination

points to which they connect) using SSL and/or early

TLS:

 Are the devices confirmed to not be susceptible to

any known exploits for SSL/early TLS

Or:

 Is there a formal Risk Mitigation and Migration Plan

in place per Requirement A2.2?

 Review documentation (for example,

vendor documentation,

system/network configuration details,

etc.) that verifies POS POI devices

are not susceptible to any known

exploits for SSL/early TLS

A2.2

Is there a formal Risk Mitigation and Migration Plan in

place for all implementations that use SSL and/or early

TLS (other than as allowed in A2.1), that includes:

 Description of usage, including; what data is being

transmitted, types and number of systems that use

and/or support SSL/early TLS, type of environment;

 Risk assessment results and risk reduction controls

in place;

 Description of processes to monitor for new

vulnerabilities associated with SSL/early TLS;

 Description of change control processes that are

implemented to ensure SSL/early TLS is not

implemented into new environments;

 Overview of migration project plan including target

migration completion date no later than 30th June

2018?

 Review the documented Risk

Mitigation and Migration Plan

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

Appendix A3: Designated Entities Supplemental Validation (DESV)

This Appendix applies only to entities designated by a payment brand(s) or acquirer as requiring additional validation of existing PCI DSS

requirements. Entities required to validate to this Appendix should use the DESV Supplemental Reporting Template and Supplemental Attestation

of Compliance for reporting, and consult with the applicable payment brand and/or acquirer for submission procedures.

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

Appendix B: Compensating Controls Worksheet

Use this worksheet to define compensating controls for any requirement where “YES with CCW” was

checked.

Note: Only companies that have undertaken a risk analysis and have legitimate technological or

documented business constraints can consider the use of compensating controls to achieve compliance.

Refer to Appendices B, C, and D of PCI DSS for information about compensating controls and guidance

on how to complete this worksheet.

Requirement Number and Definition:

Information Required

Explanation

1. Constraints

List constraints precluding compliance

with the original requirement.

2. Objective

Define the objective of the original

control; identify the objective met by

the compensating control.

3. Identified Risk

Identify any additional risk posed by the

lack of the original control.

4. Definition of

Compensating

Controls

Define the compensating controls and

explain how they address the

objectives of the original control and

the increased risk, if any.

5. Validation of

Compensating

Controls

Define how the compensating controls

were validated and tested.

6. Maintenance

Define process and controls in place to

maintain compensating controls.

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 2: Self-Assessment Questionnaire January 2017

Appendix C: Explanation of Non-Applicability

If the “N/A” (Not Applicable) column was checked in the questionnaire, use this worksheet to explain why

the related requirement is not applicable to your organization.

Requirement

Reason Requirement is Not Applicable

Example:

3.4

Cardholder data is never stored electronically

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 3: Validation and Attestation Details January 2017

Section 3: Validation and Attestation Details

Part 3. PCI DSS Validation

This AOC is based on results noted in SAQ B-IP (Section 2), dated (SAQ completion date).

Based on the results documented in the SAQ B-IP noted above, the signatories identified in Parts 3b-3d, as

applicable, assert(s) the following compliance status for the entity identified in Part 2 of this document:

(check one):

Compliant: All sections of the PCI DSS SAQ are complete, all questions answered affirmatively,

resulting in an overall COMPLIANT rating; thereby (Merchant Company Name) has demonstrated full

compliance with the PCI DSS.

Non-Compliant: Not all sections of the PCI DSS SAQ are complete, or not all questions are answered

affirmatively, resulting in an overall NON-COMPLIANT rating, thereby (Merchant Company Name) has

not demonstrated full compliance with the PCI DSS.

Target Date for Compliance:

An entity submitting this form with a status of Non-Compliant may be required to complete the Action

Plan in Part 4 of this document. Check with your acquirer or the payment brand(s) before completing

Part 4.

Compliant but with Legal exception: One or more requirements are marked “No” due to a legal

restriction that prevents the requirement from being met. This option requires additional review from

acquirer or payment brand.

If checked, complete the following:

Affected Requirement

Details of how legal constraint prevents requirement being met

Part 3a. Acknowledgement of Status

Signatory(s) confirms:

(Check all that apply)

PCI DSS Self-Assessment Questionnaire B-IP, Version (version of SAQ), was completed according to

the instructions therein.

All information within the above-referenced SAQ and in this attestation fairly represents the results of

my assessment in all material respects.

I have confirmed with my payment application vendor that my payment system does not store sensitive

authentication data after authorization.

I have read the PCI DSS and I recognize that I must maintain PCI DSS compliance, as applicable to

my environment, at all times.

If my environment changes, I recognize I must reassess my environment and implement any additional

PCI DSS requirements that apply.

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 3: Validation and Attestation Details January 2017

Part 3a. Acknowledgement of Status (continued)

No evidence of full track data

, CAV2, CVC2, CID, or CVV2 data

, or PIN data

storage after

transaction authorization was found on ANY system reviewed during this assessment.

ASV scans are being completed by the PCI SSC Approved Scanning Vendor (ASV Name)

Part 3b. Merchant Attestation

Signature of Merchant Executive Officer



Date:

Merchant Executive Officer Name:

Title:

Part 3c. Qualified Security Assessor (QSA) Acknowledgement (if applicable)

If a QSA was involved or assisted with this

assessment, describe the role performed:

Signature of Duly Authorized Officer of QSA Company



Date:

Duly Authorized Officer Name:

QSA Company:

Part 3d. Internal Security Assessor (ISA) Involvement (if applicable)

If an ISA(s) was involved or assisted with this

assessment, identify the ISA personnel and

describe the role performed:

Data encoded in the magnetic stripe or equivalent data on a chip used for authorization during a card-present transaction. Entities

may not retain full track data after transaction authorization. The only elements of track data that may be retained are primary

account number (PAN), expiration date, and cardholder name.

The three- or four-digit value printed by the signature panel or on the face of a payment card used to verify card-not-present

transactions.

Personal identification number entered by cardholder during a card-present transaction, and/or encrypted PIN block present

within the transaction message.

PCI DSS v3.2 SAQ B-IP, Rev. 1.1 – Section 3: Validation and Attestation Details January 2017

Part 4. Action Plan for Non-Compliant Requirements

Select the appropriate response for “Compliant to PCI DSS Requirements” for each requirement. If you

answer “No” to any of the requirements, you may be required to provide the date your Company expects to be

compliant with the requirement and a brief description of the actions being taken to meet the requirement.

Check with your acquirer or the payment brand(s) before completing Part 4.

PCI DSS

Requirement*

Description of Requirement

Compliant to PCI

DSS Requirements

(Select One)

Remediation Date and Actions

(If “NO” selected for any

Requirement)

YES

Install and maintain a firewall

configuration to protect

cardholder data

Do not use vendor-supplied

defaults for system passwords

and other security parameters

Protect stored cardholder data

Encrypt transmission of

cardholder data across open,

public networks

Develop and maintain secure

systems and applications

Restrict access to cardholder

data by business need to know

Identify and authenticate access

to system components

Restrict physical access to

cardholder data

Regularly test security systems

and processes

Maintain a policy that addresses

information security for all

personnel

Appendix A2

Additional PCI DSS Requirements

for Entities using SSL/early TLS

* PCI DSS Requirements indicated here refer to the questions in Section 2 of the SAQ.

Sign the document

DRAW TYPE UPLOAD

Choose file

Sending Options

Clear

Adding Fields

Fields are being added to your document to make it really easy to fill, send and sign this PDF. Once finished you can manually add any additional fields and signatures to the document by dragging them from the toolbar.

For larger documents this process may take up to one minute to complete

Finish

Download
Save PDF to desktop

Email
Email completed PDF

Send for Signing
Email for others to sign

Print
Print document

Send for signing

Email for others to sign

Choose a Field
Click on a field and
select the person that should complete it

Want to add a signature?
You can add a signature field
and assign it to someone else
to sign

Send for signing

Email for others to sign

Choose a Field
Click on a field and
select the person that should complete it

Send for signing

Email for others to sign

Someone else

NAME

Email completed PDF

Template

Convert to a reusable Template

Complete document

PCI Self-Assessment Questionnaire B-IP and Attestation of Compliance 2017

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 18 February 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document

You're on your way to completing your first doc!

already registered?

First 20 documents completely FREE!

No credit card required

Digitally sign with 1 click

Request signatures from others

Secure storage for sensitive data

Upload your own forms

Simple PDF editing

Huge library of 1000's of forms