Charity number SC004401

Purchasing Card – Temporary / Permanent (please delete as appropriate) Change of Limit(s) Request – Form 2

Cardholder Information

DATA PROTECTION
The information requested on this form may be used by the bank provider to assist in providing you with the service you are applying for, and to confirm, update and enhance the Bank’s customer records.

On completion of form return for the attention of Card Administrator (Marylise Tate).

Name on card
(Block Capitals)	
	
Departmental Address
(Block Capitals)	
	
Email Address
		
Last 4 digits of Card No.
(As embossed on front of card)	
	
PRESENT   Monthly Spend Limit
	£
	
PRESENT   Transaction Limit
	£
	
REQUESTED   Monthly Spend Limit
	£	
REQUESTED   Transaction Limit
	£	
Please state reason for Monthly/Transaction Limit change request and the date until the limit(s) should be applied.	

	

Change of Limits requested by:
Cardholder Print Name:  __________________________________
Cardholder Signature:    __________________________________
	Date: 	
Change of Limits authorised by:
Budget Holder or Line Manager Print Name:  __________________________________ 
Budget Holder or Line Manager Signature:   __________________________________
	Date:	
Head of Finance Approval:
Print Name:   __________________________________
Signature:      __________________________________
	Date:	
Head of Procurement Approval    
Josephine Gallagher 
Signature: __________________________________
 	Date: 	
Card Administrator
Marylise Tate
Limits validated and cardholder informed.  	Date: