"Cardholder Termination Form - Purchasing Card Program" - Florida

This Florida-specific printable "Cardholder Termination Form - Purchasing Card Program" is a part of the legal paperwork issued by the Florida Department of Juvenile Justice.

Download the up-to-date PDF by clicking the link below and mail it as per the guidelines provided by the department.

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Download "Cardholder Termination Form - Purchasing Card Program" - Florida

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DEPARTMENT OF JUVENILE JUSTICE
Purchasing Card Program
CARDHOLDER TERMINATION FORM
This form verifies that_______________________________________________has relinquished
(Type or clearly print name)
possession of the attached State of Florida Purchasing Card and it has been destroyed in
accordance with the Department of Juvenile Justice guidelines.
(Affix half of card here)
(Affix half of card here)
Return completed form to the Department of Juvenile Justice:
Antonio Murphy or Teresa Davis, PCard Program Office
2737 Centerview Drive
Tallahassee, FL 32399
_______
_________________________________
________________________________________
Cardholder Signature
Supervisor Signature
________________________________________
________________________________________
Date
Date
Agency Received Date: ____________________
Received by: _______________________________________
DEPARTMENT OF JUVENILE JUSTICE
Purchasing Card Program
CARDHOLDER TERMINATION FORM
This form verifies that_______________________________________________has relinquished
(Type or clearly print name)
possession of the attached State of Florida Purchasing Card and it has been destroyed in
accordance with the Department of Juvenile Justice guidelines.
(Affix half of card here)
(Affix half of card here)
Return completed form to the Department of Juvenile Justice:
Antonio Murphy or Teresa Davis, PCard Program Office
2737 Centerview Drive
Tallahassee, FL 32399
_______
_________________________________
________________________________________
Cardholder Signature
Supervisor Signature
________________________________________
________________________________________
Date
Date
Agency Received Date: ____________________
Received by: _______________________________________
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