The Cardholder fills out and signs this form and it goes to the Procurement Card Program Administrator and the Procurement Card Program Administrator Assistant for review.
When the Cardholder first comes to the webform, they need to fill out the phone number, last 8 digits of the Visa Card, their Department, their Building, their Room number, the Billing Close Date, the Transaction Date, the Reference number, the Merchant Name, the Merchant Location, and the Posted Amount.
Once they fill out that information and enter the form, they need to select the reason for the dispute, attach the appropriate documentation (if required), and sign their name.
Then, the form goes to the PCPA and PCPAA for review.