Neuroscience PCard Order Form

Purchaser Information

Today's Date

mm/dd/yyyy

UA Financial Doc #

Organization/Department Number

PCard Holder Name

PCard Last 4 Digits

Purchase made for (if different than cardholder)

Purchaser Email

Vendor Information

Vendor

Vendor Contact (Email and/or Phone)

Transaction Information

Order Date

mm/dd/yyyy

Detailed Business Purpose

Please include how the purchase directly benefits the UA and the account being charged.

https://financialservices.arizona.edu/accounting/business-purpose

Transaction Dollar Amount

Tax Exempt?

Account Number

Enter additional accounts below in Notes if order will be split

Sub Account Number

Project Code

Travel Authorization

If the purchase is related to travel, please provide the Travel Authorization number and a Business Purpose for all upgrades and additionals (ie: Early Bird Check-in, additional luggage, etc.)

You MUST also upload your completed Travel Authorization Form in the Attachments.

Notes

Indicate account split percentages, tip and tax breakout, or other notes related to the purchase here.

File Upload

Please attach the purchase receipt/confirmation here. PDF and/or JPEG are acceptable.

Drop your files here

Send me a copy of my responses

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