JP Morgan Chase Corporate Master Card Application
Cardholder Information
New Card
Change (complete fields to be changed)
Name as you would like it to appear on the card
9 9 9 9 9
ecurity Identifier (last 4 unique digits)
Required for bank authentication
Campus Department
Departmental Account Number
Date of Birth
Complete Beloit College Email Address
Mother’s Maiden Name (4 letters only)
Campus Phone Number
Cell Phone Number With Area Code
Country of Citizenship
Complete Home Address
Credit Information
Purpose of the Card: Frequent Business Travel Supplies and Services Other: __________________
Credit Limit Requested: $2000 $5000 Other: ___________
Credit Card Agreement
Corporate credit cards may not be used for cash advances (ATM machines) or personal goods and services. If a card is lost or stolen,
the cardholder must immediately contact the card issuer at 1-800-316-6056 and the College Accounting Office at 608-363-2206.
It is the cardholder’s responsibility to obtain original receipts from the merchant and/or supplier each time the card is used.
Payment Distribution Forms must be completed and returned to the Accounting Office with all supporting documentation and
approvals. The forms are due on the last day of the month in any month with credit card activity. Failure to return the form
within 30 days of the due date may result in credit card suspension or revocation.
ll credit card purchases are subject to the College’s Travel and Expense Reimbursement Guidelines. Any personal use or misuse of
the credit card will be deducted from my payroll check as a personal advance. Failure to adhere to corporate credit card policies will
result in card suspension, revocation, and/or appropriate disciplinary actions.
have read and agree to the above terms and conditions.
____________________________________________ __________
Signature of Employee/Cardholder Date
Approval of Department Head
Approval of Vice President/Senior Staff
click to sign
click to edit