Fillable PC Maintenance (Southeast Missouri State University)

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PC Maintenance (Southeast Missouri State University)

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Card Maintenance Request
FRD : 04/27/18
FCD : 4/8/2014
Date:
Complete for changes on an existing Purchasing Card.
Supervisor Signature: Date:
TYPE OF CHANGE REQUESTED
(check all that apply)
EXPLANATION OF REQUEST
Southeast ID:
Department
Campus Address
Other
Unblock a Merchant Code
Default Index Code
Single Transaction Limit
Cardholder Name
Monthly Transaction Limit
Last 4 digits on card:
Cardholder Name:
Cardholder Signature:
FOR USE BY ACCOUNTS PAYABLE OFFICE ONLY
SEND COMPLETED FORM TO: purchasingcard@semo.edu
Request Received: Request Change Made by:
Additional Notes:
Date:
Temporary Permanent
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PC Maintenance (Southeast Missouri State University)

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Completed 26 July 2020

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