Fillable Pcard Authform (University of Dayton)

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Pcard Authform (University of Dayton)

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The Pcard Authform (University of Dayton) form is 2 pages long and contains:

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Country of origin: US
File type: PDF

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Instructions for Pcard Authorization Letter
1. Complete all blanks on the letter. To overwrite the lines with underlined text,
press your insert key until you see OVR highlighted at the bottom of the screen
and turn on your underline. This will fill in the blanks without your needing to
delete anything.
2. Feel free to change the wording from “following number” to “last four digits” in
instances where you do not want the full 16 digits of the credit card on this letter
or when the user will have the plastic with them.
3. Please remember that this letter provides all information needed to process a
transaction on this card and will need to be safeguarded by whoever has the letter.
If the letter falls into the wrong hands, fraudulent charges could be placed on the
card.
4. Print the second page of this document on your University letterhead. You do not
need to print these instructions.
5. Be sure to keep a copy of this letter with your transaction log so you have record
of who you allowed to use your card.
6. A copy of this letter may be left with the vendor if they require it for their records.
7. The person to whom this letter is issued should return it to the cardholder with the
appropriate receipts attached. The cardholder should place this with their
transaction log.
8. The tax exempt certificate can be obtained from the Purchasing Department. The
Purchasing Office can fax a copy of the tax exempt certificate to the vendor if
necessary.
9. You may want to point out the 3-digit “trailing numbers” on the signature panel of
the Pcard to the user so they are aware of them should the vendor request these
numbers
.
10. This form may be used with multiple vendors by copying the vendor information
lines and completing them for each vendor. These purchases should be made
within a very short time span (ie a day or two). If they cannot be completed in a
timely manner, you should complete separate authorization forms.
04/02/02
Purchasing Card (Pcard) Use Authorization Letter
Date: ______________
To Whom It May Concern:
I, ____________________________________, authorize ______________________________________to
use my University of Dayton Pcard. This card is a VISA card with the following number:
_______________________ and expiration date: _________. It has been authorized for use for the
following purchase(s):
1. Vendor name & address: ________________________________________________
________________________________________________
________________________________________________
Vendor phone number: ________________________
Amount not to exceed: ________________________
Description of Purchase: _______________________________________________
_______________________________________________
_______________________________________________
2. Vendor name & address: ________________________________________________
________________________________________________
________________________________________________
Vendor phone number: ________________________
Amount not to exceed: ________________________
Description of Purchase: _______________________________________________
_______________________________________________
_______________________________________________
Please ask for appropriate identification. All purchases made on this Pcard will be exempt from sales tax.
The University’s tax identification number is 31-0536715. The purchaser can supply you with our tax
exempt certificate should you need it for your records.
Please do not hesitate to contact myself should you have any questions. Also, you may contact Angie
Buechele, Pcard Coordinator at (937) 229-2946 or Ken Soucy, Director of Purchases at (937) 229-2607 for
further assistance.
Thank you for your assistance with this request.
Signature of Cardholder Title
Date
Signature of Authorized User
Date
Contact Phone Number(s) of Cardholder
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Pcard Authform (University of Dayton)

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Completed 21 July 2020

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