Form

Purchasing Card Statement Submission Form

Policies

https://www.uwlax.edu/business-services/pcard/

Roles

Initiator: The individual initiating the purchasing card statement form. This role provides the contact information for each role and uploads the purchasing card statement and supporting documentation. This will often be the same person as the cardholder.

Cardholder: The cardholder that the statement is being uploaded for. This will often be the same person as the initiator.

Cardholder Supervisor: The supervisor of the cardholder who will approve the purchases.

Procurement: The pcards@uwlax.edu email address where these statements are processed. This field cannot be changed by the initiator.

Instructions

Use this form to submit purchasing card statements and supporting documentation to the Procurement office in Business Services. Each purchasing card statement should be submitted separately and multiple statements should not be combined using this form. This form is set up as a DocuSign PowerForm.

The initiator of the form will provide the cardholder and supervisor contact information to route the form, along with the purchasing card statement and documentation to be approved. Business purpose information should be provided on the PDF statement before uploading to DocuSign. The purchasing card statement and supporting documentation will be attached using the file attachment control at the bottom of this form.

By initiating this form:

1. The initiator will receive a notification email that can be used to track the approval of the form.
2. The cardholder will receive a notification to review and approve the attached statement and supporting documentation below (this will often be the same person as the initiator).
3. The cardholder’s supervisor will receive a notification to review and approve the attached statement and supporting documentation.
4. Once the supervisor has signed, the initiator, cardholder, cardholder’s supervisor, and the Procurement office purchasing card email (pcards@uwlax.edu) will receive a copy of the completed form.

Questions

Please contact the Procurement staff at pcards@uwlax.edu with any questions about using this form.

Form Layout

The form layout, along with the roles that complete each section of the form, are as follows: