Credit Card Reconciliation Form
Please submit the following information for each receipt. Then, please attach, give or send the receipt (electronic or paper copy) to Jalene McDonald or Lisa Norton (depending on whose credit card was used).
Full Name: *
Vendor (company) *
What purchased? *
Please write one or more sentences describing the business purpose (including the type of research if applicable): *
Name of Research Study (for gift cards):
Total cost: *
For whom purchased? (for yourself, for the department, or for someone with whom you work) *
Net ID of purchaser: *
Operating Unit to pay for purchase: (By Last Name or Area) *
Category of Purchase (Listed by Number) *
Class Code for Purchase (typically the first initial of first name and the first four letters of last name or five zeros (00000) if unrelated to a person) *
Any other information?
Please attach receipt here (preferred) or email after submitting this form:
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