NOTICATION OF PURCHASING CARD DISCREPANCY/ VIOLATION FORM Today’s Date: Cardholder’s Name: Purchasing Card Account #: Supervisor/Budget Head’s Name: Form Initiated By (Check one): CARDHOLDER SUPERVISOR/BUDGET HEAD PURCHASING CARD ADMINISTRATOR Date(s) of Discrepancy/Violation: Describe Discrepancy/Violation: - (Give date(s), details and describe nature of the discrepancy or violation (i.e., policy/procedure violation, card misuse, card abuse, as per Purchasing Card policy) Describe/Explain Circumstances... Attach supporting documentation, if necessary.) Description/Dates of Previous Discrepancy/Violations for Card Account in the last 12 months: _________________________________ __________________________________ _______________ Signature...
Allowed
Adobe Portable Document Format (.pdf) - application/pdf
3300-015 Purchasing Card Notification of Discrepancy- Violation Form 10-26.pdf
DELGADO FORMS 
