UNIVERSITY OF WEST GEORGIA
P-CARD APPLICATION & CHANGE REQUEST FORM
Appendix A
Check the appropriate box for the type of request:
New Cardholder Request
Cardholder Change Request
Cardholder Name:
Department Name:
Phone#:
Email:
Primary Cost Center/
Departmental
Account#:
Department Head/
Supervisor:
To request changes in spend limits, please complete sections below:
Single Transaction
Limit Amount
Monthly Credit
Limit Amount
Justification
for
Changes:
By signing below, I confirm that I have read and understand the UWG P-Card Policy
Manual.
Signature: _________________________________________
Cardholder
Date: _____________________________________________
Signature: _________________________________________
Department Head/Supervisor
Date: _____________________________________________
For Official Use Only
Approval Date:
Card Order Date:
Card Receipt Date:
If not approved, please state reason below:
_______________________________________________________________________________
_______________________________________________________________________________
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