Procurement Card Application-Change of Department

Procurement Card Application

Change of Department

Click on the submit once you have completed the form, a copy will be forwarded to your email account. Gather additional signatures from your approving official, forward a signed copy to procurement: Procurementcard@calstatela.edu

EMPLOYEE INFORMATION

Last Name: *

First Name *

Middle Initial

5151 State University Dr.

Los Angeles CA 90032-4226

Department

Building

Room#

Business Phone

Your Email Address *

EmployeeID *

COMPANY INFORMATION

California State University, Los Angeles

5151 State University Dr., ADM-514

Los Angeles, CA 90032-4226

Monthly Credit Limit *

Single Transaction Limit *

Name of Approving Official-PRINT *

Name of Alternate Approving Official-PRINT

CHARTFIELD *

EMPLOYEE

Date * +

* PLEASE RETURN TO OFFICE OF PROCUREMENT AND CONTRACTS, ADM-501. PLEASE CONTACT 323/343-3487 MARINA JAUREGUI, PROGRAM ADMINISTRATOR, IF YOU HAVE QUESTIONS. YOUR CARD SHOULD ARRIVE WITHIN 5 BUSINESS DAYS, AT WHICH TIME YOU WILL BE CONTACTED.
(Rev. 03/15)