Fillable Purchasing-card-application Southern Utah University

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Purchasing-card-application Southern Utah University

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Southern Utah University
Purchasing Card Application
This application is to be submitted upon completion which includes obtaining all the required
approvals. Only one (1) departmental account can be attached to each Purchasing Card and an
employee may only be issued one (1) card. Please see the procedures when purchasing from
multiple accounts.
Cardholder Full Legal Name _______________________________________________
Preferred Name on the Card (if different than legal name) _____________________________
Social Security # (Last Four Digits ONLY) T-Number ___________________
Cardholder Signature ________________________ Date ______________
Department ______________________________
Departmental Account Number ______________________________
Departmental Account Manager * ______________________________
Department Manager E-mail ______________________________
Account Manager Approval * Supervisor Approval
* Person who will be responsible within the department to receive and reconcile monthly billing
statements.
For Office Use Only
Division Number __________________ Department Number ___________________
E _____ A _____ B_____ IA_____
Availability to use for Non-Travel meals purchases (check one) Yes No
(If requesting this capability, this application must have an explanation attached and be approved by
the SUU Controller and the Director of Purchasing prior to submitting)
Controller Director of Purchasing
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Purchasing-card-application Southern Utah University

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Completed 20 November 2019

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