Instructions for Form FMS-103-F5 Exhibit I "Pending/Missing Pc Alert Receipt Form" - Florida

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EXHIBIT I
INSTRUCTIONS FOR COMPLETING THE PENDING PC ALERT FORM
Cardholder Name - --Name of person who authorized the transaction.
Ordered Date-----------This is the date the ordered was made with the merchant.
Vendor Name-------------Name of the merchant from which the purchase was made.
Purchase Amount- ------ This is the total amount charged or credited to the purchasing
card on a single transaction.
Description of Purchase- Describe the type of merchandise being purchase.
Quantity Ordered----------- Number of what’s being ordered.
DO/MA Number-------------- This is the generated number obtained from MFMP.
Shipping and Handling-------What the vendor charge for shipping.
Other Charges-------------------Describe if the transactions is for an Erroneous charge,
Credit, Duplicate Charge etc.
Receipt Check------------------ Check if receipt was lost or not received.
Signatures------------------------- Cardholder/Supervisor must sign the missing receipt
form.
10/3/2008
FMS-103-F5 – Travel
Pending/Missing PC Alert Receipt Form
Exhibit I
EXHIBIT I
INSTRUCTIONS FOR COMPLETING THE PENDING PC ALERT FORM
Cardholder Name - --Name of person who authorized the transaction.
Ordered Date-----------This is the date the ordered was made with the merchant.
Vendor Name-------------Name of the merchant from which the purchase was made.
Purchase Amount- ------ This is the total amount charged or credited to the purchasing
card on a single transaction.
Description of Purchase- Describe the type of merchandise being purchase.
Quantity Ordered----------- Number of what’s being ordered.
DO/MA Number-------------- This is the generated number obtained from MFMP.
Shipping and Handling-------What the vendor charge for shipping.
Other Charges-------------------Describe if the transactions is for an Erroneous charge,
Credit, Duplicate Charge etc.
Receipt Check------------------ Check if receipt was lost or not received.
Signatures------------------------- Cardholder/Supervisor must sign the missing receipt
form.
10/3/2008
FMS-103-F5 – Travel
Pending/Missing PC Alert Receipt Form
Exhibit I
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