Fillable P Card New Cardholder Application SAMPLE (Idaho State University)

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P Card New Cardholder Application SAMPLE (Idaho State University)

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Idaho State University Purchasing Card Handbook dated Nov. 1, 2016, Appendix I, Page 10
Cardholder Application
Please complete all fields
Cardholder Name:
(As it will appear on card, including middle initial - maximum 24 characters)
Agency Name or Division: IDAHO STATE UNIVERSITY
University Department: Campus:
(
Pocatello, IF, Meridian, etc
.)
Statement Mailing Address: 638 E DUNN STREET
POCATELLO, IDAHO 83209 -
(
Stop #
)
E-Mail Address: User Name (Your 4x4):
Work Telephone: ( ) -_
Supervisor’s Name:
Area code
Cardholder Signature/Date Supervisor Signature/Date
Overall Monthly Limit: $ 10,000
Single Purchase Limit: $ 2,000
Daily Transaction Limit: $ 6,000
Approver/Manager: Reconciler:
UBO: Default/Local Index Code:
Agency Purchasing Card Administrator Signature/Date
Cardholder Information:
Spending limits:
Approvals
For Purchasing Only
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P Card New Cardholder Application SAMPLE (Idaho State University)

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Completed 21 July 2020

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