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Safekeeping Visa Check Out Fillable

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Safekeeping Prepaid Visa Request
Please allow at least 3-4 business days for processing time.
Safekeeping Group ________________________________________________________________________________
Person Picking Up Prepaid Visa ______________________________________ WSU ID ________________________
(Must present a valid ID at time of pick up)
WSU Email Address__________________________________ Contact Phone Number __________________________
Date of Check Out _________________________________ Check In Date __________________________________
Amount to be Loaded onto Prepaid Visa $________________
(Please justify for amounts greater than $500.00.)
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Description of Event or Use of Card __________________________________________________________________
_______________________________________________________________________________________________
• I accept full responsibility on behalf of the above named Safekeeping group for the care of the Prepaid Visa that is
being borrowed and all purchases made with the card. The Safekeeping group will be charged a fee in the
amount of $40.00 should the card become damaged, lost or not returned.
• I understand on behalf of the above named Safekeeping group that the Prepaid Visa must be returned by the said
above date to avoid a $40.00 late fee charge.
• The Prepaid Visa card, which allows access to funds loaded, should be treated with the same care as cash. The
card is not connected in any way to any other account, is not a gift card and is not intended to be used for
purchase of services. You can use for an online purchase; however, do not save the card number as a payment
option. NEVER place the card number in an email.
• Prepaid Visa is not available for cash withdrawals.
• I agree that I, as the authorized designee of the Safekeeping group, will ensure that instructions on the use of the
Prepaid Visa are fully understood and any violation will be forwarded to Conduct.
• I understand that all receipts for the purchases made on the Prepaid Visa must be turned in to Accounts
Receivable when returning the Prepaid Visa card to avoid a $40.00 fee.
Signature (Responsible Person) ___________________________________________ Date _____________________
Signature (Safekeeping Advisor) ___________________________________________ Date _____________________
Financial Operations Office Use Only:
Checked Out By ___________________________________________________________________ Date ________________________________
Checked In By ____________________________________________________________________ Date ________________________________
Fund/Org __________________________________________ Last 4 digits of card _______________________________
Revised 03/21/2018
Information on Use of Prepaid Visa:
In order to aid student organizations in the purchasing process, Wichita State University Financial Operations and
Business Technology has a Prepaid Visa program. The Prepaid Visa can be directly loaded with funds from the
organization’s Safekeeping account (not personal funds). Any organization wishing to take part in this program must
adhere to the following stipulations:
• Organizations must have a Safekeeping account set up with the university.
• Organizations must have adequate money in their Safekeeping account to cover money transferred to the
Prepaid Visa.
• Organizations must request the use of a Prepaid Visa from Financial Operations a minimum of three (3) business
days prior to the proposed date of checkout.
• Only students and advisors named as signatories on the Safekeeping account may request the use of a Prepaid
Visa.
• Organization advisors must approve and sign-off on any use of the Prepaid Visa.
• Organizations may load up to $500 on the Visa for any event’s or traveler’s expenses. Additional funds may be
loaded with pre-approval.
• Any funds not used by the organization will be transferred back to the group’s Safekeeping Account.
• All purchases made with the Prepaid Visa must be in compliance with all university policies and procedures.
o Any purchases made violating university policies and procedures will be charged back to the student or
staff member that checked out the card from Financial Operations.
• In some circumstances, receipts must be turned in to Student Involvement within two (2) business days of
purchase for event expenses or within two (2) business days of the date of return for travel expenses. Be sure to
take this into consideration when stating the Check In Date for the prepaid card on the Safekeeping Prepaid Visa
Request form. Be aware that all transactions are subject to internal review.
• The university has blocked certain types of retailers like liquor stores, casinos and adult entertainment locations.
• Careful attention should be given to over-the-phone purchases. Make sure the merchant uses the correct zip
code; otherwise, it could be declined.
Revised 03/21/2018
Safekeeping Prepaid Visa FAQ
What do I do if my card malfunctions or is lost or stolen?
Contact Accounts Receivable immediately (see below). If outside business hours, leave a message.
What do I do if my card is damaged?
During business hours, bring the card to Accounts Receivable.
Are there any fees associated with the card?
Yes, a $40.00 fee will be charged for the following:
• Lost, Non-Returned or Damaged Card
• Late or No Receipts Provided
What if I overdraft?
Spending should not exceed the available balance on the card; however, if a negative balance occurs, your student group
is responsible to reimburse the card.
How can I check the balance on my card and keep track of my purchases?
• Call Customer Service at 1-844-688-4720.
• Be prepared to provide:
o Card number
o Birthdate of 01/01/1975 (do not use your own personal birthdate)
o Address of 1845 Fairmount Box 38, Wichita, Kansas 67260-0038
o Expiration date
o CSV on back of card
Will I be able to make an online purchase with this card?
Your card allows you to make a purchase online; however, when prompted for the billing address, you need to make sure
you put in WSU’s address of 1845 Fairmount Box 38, Wichita, Kansas 67260-0038. Remember that the card number
should not be saved as a payment option nor should the card number be written in an email.
Are there any special types of transactions I should know about before I shop?
• Gas Stations - If you use your card at an automated fuel dispenser (i.e., pay at the pump) it may result in a hold
on your funds of $75.00 or more. To avoid this hold, you may go into the gas station and pay the cashier for your
purchase in advance, and specify the exact dollar amount of gas you would like to purchase.
• Restaurants and Other Merchants - Restaurants, hair salons and some other types of merchants may obtain an
authorization on the card for an amount greater than the total service bill to cover any gratuity that may be added.
Be sure that the balance on the card is sufficient to cover the cost of the bill plus any anticipated gratuity. If the
card is declined, asked the merchant to obtain an authorization for an amount equal to or less than the balance on
your card. Pay the difference with another form of payment.
• Hotels - Hotels may put a hold on your card in the amount of your estimated bill, which will make that amount
unavailable for other purchases. The hold may last from the time you check in to a few days after you check out.
• Auto Rentals - Auto rental establishments may require you to reserve your car with a credit card. They may allow
you to use your card for the final payment. Please check with the establishment for their specific procedures.
For further information, contact:
Phone: (316) 978-3333
Email: wsuaccountsreceivable@wichita.edu
Website: www.wichita.edu/safekeeping
Business Office Hours: Monday-Tuesday 8:00 a.m. – 6:00 p.m. and Wednesday-Friday 8:00 a.m. – 5:00 p.m.
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Completed 10 March 2020

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