Fillable ELECTRONIC COMMERCE CARD APPLICATION FORM (Knox County)

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ELECTRONIC COMMERCE CARD APPLICATION FORM (Knox County)

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The ELECTRONIC COMMERCE CARD APPLICATION FORM (Knox County) form is 1 page long and contains:

  • 7 signatures
  • 3 check-boxes
  • 26 other fields

Country of origin: US
File type: PDF

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ELECTRONIC COMMERCE CARD APPLICATION FORM
TYPE OF CARD: Electronic Commerce Card Travel Card Contract Card
CARDHOLDER INFORMATION: (if generic card, list the card name)
Generic Name:
First Name:
Middle Initial:
Last Name:
E-Mail Address:
Business Phone Number:
BILLING STATEMENT ADDRESS
Department Name:
Division:
Street Address:
City:
State:
WHAT COMMODITIES DO YOU PLAN ON PURCHASING WITH THIS CARD?
CREDIT LIMITS Monthly Credit Limit Single Transaction Limit
CARD USE APPROVED PERSONNEL (For Generic Card Use Only): (please print names)
1._______________________________ 2.________________________________
Cardholder Signature: ______________________________________ Date: ___________
Department Head Signature: ________________________________ Date: ___________
Elected Official Signature: __________________________________ Date: ___________
Program Manager: _________________________________________ Date: ___________
Director of Procurement Signature: ______________________________ Date: ___________
Director of Financial IT & Compliance Signature: ___________________ Date: ___________
Director of Finance Signature: _______________________________ Date: ___________
County Mayor Signature: ___________________________________ Date: ___________
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ELECTRONIC COMMERCE CARD APPLICATION FORM (Knox County)

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Completed 6 August 2020

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