Billing Adjustment Customer Name* Customer Number* Adjustment Type*- Select One -Set UpNew LaunchOne-time ChargeAdd Recurring ServiceRemove ServiceBudget IncreaseBudget DecreaseCredit MemoRefundPause BillingResume BillingCancelled AccountRetention AdjustmentAgreement*Max. file size: 8 MB.Is This An Upgrade?* Yes No New LaunchNew Launch*- Select One -MailDeNovoDigitalCombinedFull Website OnlySetup FeeIs This Recurring?* Yes No New Launch Monthly Charge Amount*Process* Immediately 1st of Month 15th of Month New Launch One-time Charge Amount*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 OnlyMailEmail CreationCitation BurstsRecurring Service Monthly Charge Amount*Set Up Fee?* Yes No Recurring Service Set Up Fee Amount*Process* Immediately 1st of Month 15th of Month Remove ServiceService To Remove* Budget IncreaseIncrease Which Service?*- Select One -FacebookGoogle AdsBingWazeNew Increased Budget Amount*Budget Increase Start Date* Immediately New Increased Ads Management Fee Amount*Process Budget Increase* Immediately 1st of Month 15th of Month Budget DecreaseDecrease Which Service?*- Select One -FacebookGoogle AdsBingWazeNew Decreased Budget Amount*Budget Decrease Start Date* Immediately New Decreased Ads Management Fee Amount*Process Budget Decrease* Immediately 1st of Month 15th of Month 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 AmountAds Management FeeSet Up FeeApproval / SubmitterApproved By*- Select One -John DonatoSubmitted By* First Last Email*
