The cardholder should complete the top section of the form as indicated. Please note that the full, legal name (middle initial is acceptable) of the cardholder is required.
It is the responsibility of the department chair/head to list the default worktags that encumbrance and all charges will be paid from unless reallocated online during the reconciliation process.
The single transaction limit and monthly limit are the dollar limits that the department chair/head establishes, or will allow, for the individual listed on the form to spend per transaction and per month. Each P-Card has a single transaction credit limit of $500 (including shipping/freight and taxes) and a monthly expenditure limit of $2,500. The department chair/head should select either the default credit limits OR request a single transaction limit and a monthly expenditure limit by completing the second checkbox/line.
The department chair/head should list the person(s) who will serve as the P-Card coordinator(s) for the department. The cardholder can also be a coordinator.
This form is designed to accept electronic signatures when opened in Adobe Reader. Once appropriate signatures have been obtained, return the completed form to Procurement Services for processing.
Please contact Procurement Services at 501-916-3144 or procurement@ualr.edu if you need assistance completing this form or have other questions.
