Rev 02/17
Louisiana State University
Office of Accounting Services
Bursar Operations
125 Thomas Boyd Hall
REQUEST FOR USE OF CREDIT CARD TERMINAL AS538
(MasterCard, VISA, Discover and American Express)
I request use of the Credit Card Terminal for the purpose described above. I have read and will abide by LSU’s
FASOP: AS-22 “Credit Card Merchant Policy”. Form AS539 “Responsibilities of Credit Card Handlers and
Processors” is attached for each employee entrusted with handling or processing credit card information and
these employees have read their responsibilities listed below and signed acknowledging such.
At the end of each business day, the appropriate employee(s) in the department will have the responsibility of
performing the following tasks:
• Close out that day’s business and produce a batch report; and
• Forward the original batch report to Bursar Operations to prepare a CARD entry to record revenue and
charge the transaction fee amount. A copy of the CARD entry along with 1 copy of the batch report will be
sent to the department.
I understand a fixed transaction fee of 2.5% as well as chargebacks and any additional fees will be charged to the
department. I also understand the credit card terminal should be returned to Bursar Operations in a timely
manner.
Employee(s) ___________________________________________ _______________________
Date
___________________________________________ _______________________
Date
___________________________________________ _______________________
Date
Approved by ___________________________________________ _______________________
Department Head Date
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FOR ACCOUNTING SERVICES USE ONLY
Processed by __________________________________________ Date ___________________
Department
Contact
Phone Fax E-mail
Dates Needed Start End
(Exact location where Credit
Card Terminal will be used)
Purpose
Driving Worktag: Spend Category: Ledger Account:
