Form
Information and Tips for Completing Form
Opening Statements: Read carefully. Repeated use of the form as a substitute for a receipt may result in suspension or cancellation of the PCard.
Why is the receipt missing? Provide a detailed explanation of the reasons the receipt is missing.
What attempts have been made to request a duplicate receipt from the merchant? Include names, dates, phones numbers or emails used in requesting documentation from the merchant. Most merchants can easily print a duplicate if the request is timely. If duplicate invoice is not available, then fill out the Missing Receipt form. Be sure to include all this documentation and information with the Missing Receipt form.
Itemize the purchase: Provide a detailed description and price for each item purchased. This information is very important and may be verified with the merchant.
Signatures: The responsible Cardholder, Liaison, and Department Head are required to sign this form. These signatures cannot be delegated and will be verified.