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.3/22/2017, V1
This form verifies that ___________________________ has relinquished possession of the attached Florida
Polytechnic University Purchasing Card, and it has been destroyed in accordance with FPU policies and
procedures.
[Affix card halves above]
________________________________________
Procurement Sign
Return to the Purchasing Card Page or the Forms Page.
FLORIDA POLYTECHNIC UNIVERSITY
EXPENSE CARD PROGRAM
Cardholder Termination/
Transfer Form
Date: __ / __ / __
click to sign
signature
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