Billing Adjustment Customer Name*Customer Number*Adjustment Type*- Select One -Set UpOne-time ChargeAdd Recurring ServiceRemove ServiceCredit MemoRefundPause BillingResume BillingCancelled AccountRetention AdjustmentIs This An Upgrade?* Yes No New LaunchNew Launch*- Select One -Direct MailNew ClientNewslettersAmount?*Client Email* Agreement*Max. file size: 8 MB.One-time ChargeOne-time Charge Item*- Select One -BrandingDirect Mail Ala CarteWebsite DevelopmentPhotoshootVideo ShootPhotoshoot/Video ShootEmail CreationRebill ChargebackOtherOther One-Time Charge Item*One-time Charge Amount*Process* Immediately 1st of Month 15th of Month Add Recurring ServiceAdd Recurring Service*- Select One -Full Pack PlanSEO Only PlanSocial Media PlanHosting OnlyDirect MailEmail CreationCitation BurstsRecurring Service Monthly Charge Amount*Process* Immediately 1st of Month 15th of Month Remove ServiceService To Remove*Credit MemoCredit Memo Amount*RefundRefund Which Service?*Refund Amount*Pause BillingPause Which Service?*Pause Date* Immediately Resume BillingResume Which Service?*Resume Date* Immediately Resume Monthly Charge Amount*Cancelled AccountReason for Cancellation*Last Day of Service*Retention AdjustmentRetention For Which Service?*Retention - Is This Recurring?* Yes No Retention One-time Charge Amount*Recurring Monthly Charge Amount*NotesNotesCommissionIs There A Commission?* Yes No SummaryTotal Adjustment AmountApproval / SubmitterApproved By*- Select One -John DonatoSubmitted By* First Last Email*
