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Note to Applicant:

Once this has been signed and reviewed by all you will receive an e-mail with the completed form and notes from Procurement as to whether or not it has been approved.

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Signature HereDepartment Head Will Sign Here

09/25/2026

Signature HereFinance Will Sign Here

Signature HereClick to Sign

09/25/2026

09/25/2026Click to Sign

Signature HereAndrew Valencia Will Sign Here

09/25/2026

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Note to Applicant:

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Credit Card Purchase Request

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Note to Applicant:

Once this has been signed and reviewed by all you will receive an e-mail with the completed form and notes from Procurement as to whether or not it has been approved.

Sign Now!

Please provide accurate information below to ensure the delivery of the signed copies of the document.

Listed Signers

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Andrew Valencia