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*This form is supposed to be filled out as a part of the “PO_Purchasing Card Packet” but a singular copy is retained just in case only this form needs to be filled out.

This form first goes to the Cardholder to fill out and sign, then the Department Head.

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Once they enter the form, they will check whether they’re they are:

  • authorizing a cardholder

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  • authorizing a proxy for a cardholder

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  • authorizing for “view only” access

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No matter what they choose, they will have to fill out a name, email, and chart string.

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