"Cardholder Profile Information Form - Florida Purchasing Card Program" - Florida

Cardholder Profile Information Form - Florida Purchasing Card Program is a legal document that was released by the Florida Department of Juvenile Justice - a government authority operating within Florida.

Form Details:

  • Released on September 18, 2018;
  • The latest edition currently provided by the Florida Department of Juvenile Justice;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Florida Department of Juvenile Justice.

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Download "Cardholder Profile Information Form - Florida Purchasing Card Program" - Florida

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EXHIBIT V
Cardholder Profile Information for Purchasing Card Module
Form Field Descriptions and Instructions
This form, part of it already completed, is to be signed by the Senior Manager or Select Exempt Manager or their designee and the DJJ PCPA.
Effective Date - Indicate the date the action is to be effective.
Action Requested (Always include the cardholder’s name and People First ID Number on any of the following changes):
~Add - Check if you are requesting a new card or setting-up a new Cardholder.
~Change Cardholder Name Only - Check this box and indicate both the old and new name. Add the new name in the field titled “Cardholder Information” (see below).
~Change/Other Maintenance - Check this box if the MCC, authorization controls, or other accounting information is changing. Indicate the cardholder’s name and revised
information in the appropriate form fields.
~Close Account - Check this box if the card is being canceled.
~Other, please describe - Check this box for changes such as cardholder address or phone numbers. Indicate the cardholder’s name and changed information in the
appropriate form fields.
Cardholder Name: Name as it will appear on the Purchasing Card (first name, middle name or initial, last name). This must match the Cardholder’s Name on their
Personnel Record.
Cardholder Information: Indicate all elements of the cardholder’s business information. Indicate the entire telephone number, followed by the SC prefix for the number.
(You may need to use this field to add new names - See “Change Cardholder Name Only” above.)
Merchant Category Data: Use this area to assign the appropriate MCCG to a Cardholder. Strike through the MCCGs that should be unblocked.
Other Information: Not applicable unless there is a need to use foreign currency. Contact the DJJ PCPA for information.
Peoples First ID: Cardholder’s Peoples First identification number.
Cardholder Authorization Controls: (Limits on this form are a maximum of $1,000 for each line item. Please complete the Cardholder Limits Exception Request
Form to increase a Cardholder’s Limit.)
~Credit Limit - Cardholder’s monthly spending limit.
~Single Transaction Limit - Will not exceed $1,000 per transaction.
~Daily, Monthly, Cycle Dollar Limits - Indicate the limits for the cardholder’s cumulative transaction dollar amounts for the period.
~Daily, Monthly, Cycle Transaction Limits - Indicate the limits for cumulative transaction count for the period. (N/A initially)
Agency Accounting Information:
~Org, EO, VR - Indicate the default FLAIR information.
~Object Code - If you want transactions to default to a single object code, indicate the object code.
~Group Identifier - Indicate the Approval Group to which the cardholder is assigned.
~Account Distribution Capability - Indicate “Yes” only if the cardholder will add, change and/or distribute accounting information. This may be the case if an Approver
is also a cardholder.
~FLAIR ID - If the cardholder will have access to the Purchasing Card Module because they will review and distribute their own charges, HQ will add their Access ID to
the form. In addition to this form, a Request for FLAIR Access ID must be submitted as for any approver to have an ID number assigned.
~Levels of Approval Required - Indicate the level(s) of approval required for this cardholder.
Revised September 18, 2018
EXHIBIT V
Cardholder Profile Information for Purchasing Card Module
Form Field Descriptions and Instructions
This form, part of it already completed, is to be signed by the Senior Manager or Select Exempt Manager or their designee and the DJJ PCPA.
Effective Date - Indicate the date the action is to be effective.
Action Requested (Always include the cardholder’s name and People First ID Number on any of the following changes):
~Add - Check if you are requesting a new card or setting-up a new Cardholder.
~Change Cardholder Name Only - Check this box and indicate both the old and new name. Add the new name in the field titled “Cardholder Information” (see below).
~Change/Other Maintenance - Check this box if the MCC, authorization controls, or other accounting information is changing. Indicate the cardholder’s name and revised
information in the appropriate form fields.
~Close Account - Check this box if the card is being canceled.
~Other, please describe - Check this box for changes such as cardholder address or phone numbers. Indicate the cardholder’s name and changed information in the
appropriate form fields.
Cardholder Name: Name as it will appear on the Purchasing Card (first name, middle name or initial, last name). This must match the Cardholder’s Name on their
Personnel Record.
Cardholder Information: Indicate all elements of the cardholder’s business information. Indicate the entire telephone number, followed by the SC prefix for the number.
(You may need to use this field to add new names - See “Change Cardholder Name Only” above.)
Merchant Category Data: Use this area to assign the appropriate MCCG to a Cardholder. Strike through the MCCGs that should be unblocked.
Other Information: Not applicable unless there is a need to use foreign currency. Contact the DJJ PCPA for information.
Peoples First ID: Cardholder’s Peoples First identification number.
Cardholder Authorization Controls: (Limits on this form are a maximum of $1,000 for each line item. Please complete the Cardholder Limits Exception Request
Form to increase a Cardholder’s Limit.)
~Credit Limit - Cardholder’s monthly spending limit.
~Single Transaction Limit - Will not exceed $1,000 per transaction.
~Daily, Monthly, Cycle Dollar Limits - Indicate the limits for the cardholder’s cumulative transaction dollar amounts for the period.
~Daily, Monthly, Cycle Transaction Limits - Indicate the limits for cumulative transaction count for the period. (N/A initially)
Agency Accounting Information:
~Org, EO, VR - Indicate the default FLAIR information.
~Object Code - If you want transactions to default to a single object code, indicate the object code.
~Group Identifier - Indicate the Approval Group to which the cardholder is assigned.
~Account Distribution Capability - Indicate “Yes” only if the cardholder will add, change and/or distribute accounting information. This may be the case if an Approver
is also a cardholder.
~FLAIR ID - If the cardholder will have access to the Purchasing Card Module because they will review and distribute their own charges, HQ will add their Access ID to
the form. In addition to this form, a Request for FLAIR Access ID must be submitted as for any approver to have an ID number assigned.
~Levels of Approval Required - Indicate the level(s) of approval required for this cardholder.
Revised September 18, 2018
FLORIDA PURCHASING CARD PROGRAM
EXHIBIT V
CARDHOLDER PROFILE INFORMATION
EFFECTIVE DATE:_________
ACTION REQUESTED:
Add
Change Cardholder Name Only
Change Other Maintenance
Close Account
Other, please describe:
AGENCY NAME
Florida Department of Juvenile
CARDHOLDER INFORMATION:
Justice
CARDHOLDER NAME (24 A/N)
DIVISION/OFFICE
PEOPLE FIRST ID #
BUREAU
(PCPA will obtain by phone only)
CARD MAILING ADDRESS
SECTION
CARD MAILING ADDRESS
Department of Juvenile Justice
BUSINESS ADDRESS
CITY, STATE
2737 Centerview Drive
BUSINESS ADDRESS
ZIP
Tallahassee, Florida
CITY, STATE
PHONE NUMBER
32399-3100
ZIP
850-921-4103
PHONE
SC
Regular
MERCHANT CATEGORY (MCCG) NAME
MERCHANT CATEGORY (MCCG) DESCRIPTION
1 DJJEXCLUDE
Unblock
DJJ Excluded
(Check Box to Allow Charges)
2 DJJTRAVEL
Unblock
DJJ Travel Only
(Check Box to Allow Charges for Travel)
3 DJJCOMMODI
Unblock
DJJ Goods and Services (Check Box to Allow Charges for Goods and Services)
4
OTHER INFORMATION
CARDHOLDER AUTHORIZATION CONTROLS
AGENCY ACCOUNTING INFORMATION
Plastic: Yes
Credit Limit:
$1,000 *
Org (L1-L5):
Bypass Company MCCG table: No
Single Transaction Limit:
$1,000 *
EO:
Foreign Currency:
Yes
X No
Daily Dollar Amount:
$1,000 *
Group Identifier (9 A/N):
Foreign Currency Action:
X Decline
Daily Transactions:
N/A:
Distribution ** (Y/N):
**(Allows Cardholder to Approve Their Own Charges)
Approve
Approve but Report
Monthly Dollar Amount:
$1,000 *
Monthly Transactions:
N/A
Levels of Approval Required (1-8):
Cycle Dollar Amount:
$1,000 *
FLAIR ID:
Cycle Transactions:
N/A
*For Higher Limits Complete: Attachment IV – Cardholder Limits Exception Request Form
Manager’s (or designee) Approval:
Date:
DJJ Purchasing Card Administrator (PCPA) Approval:
Date:
Revised September 18, 2018
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