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					UNIVERSITY OF ILLINOIS
Chicago  Springfield  Urbana-Champaign

Application for University of Illinois Corporate Credit Card
(American Express Card)

To apply for an American Express Corporate Credit Card complete the two-page application and return to the address listed on the second page. Responsibilities and Policies The following responsibilities and policies are associated with the University of Illinois Corporate Credit Card:   The Corporate Credit Card is intended for valid University business travel expenses only (for example, business related air travel, car rental, hotel charges, meals). Cardholder activity is monitored through reports received from American Express. A $500 retail limit (per billing cycle) has been placed on the Corporate Credit Cards. Travel related merchants (airlines, hotels, car rentals, etc) are not subject to the retail limit. The Corporate Credit card should not be used for purchasing goods & services. The University of Illinois P-Card is intended for these types of purchases. For information on the PCard go to http://www.obfs.uillinois.edu/manual/central_p/sec7-6.html. The Corporate Card should not be utilized for personal (non-University related) transactions. The Corporate Credit Card is approved by American Express based upon the employee’s personal credit qualifications, and consequently, the Card is issued with the employee’s individual liability. It is the employee’s responsibility to pay all American Express monthly statements according to the stated terms. In the event of delinquency greater than 15 days after the due date, American Express will suspend use of the Corporate Credit Card. Termination of employment (including retirement) will result in cancellation of the Corporate Credit Card.

   

Section 15.8 of the Business and Financial Policies and Procedures manual governs the use of the University of Illinois Corporate Credit Card. http://www.obfs.uillinois.edu/manual/central_p/sec15-8.html

How many times per year do you travel on University business: Is your position classified as temporary or visiting (yes or no)? If yes, termination date:

I have reviewed and understand the responsibilities and policies associated with receiving an American Express Corporate Credit Card. By signing below, I submit my application for a Corporate Credit Card and, if issued, accept the Corporate Credit Card according to these terms.

Employee Signature

Department

Title

Date

I confirm this individual will use the Corporate Credit Card for University related travel expenditures.

Departmental Approval Signature

Title

Date

Print - Departmental Approval Name

Phone Number

UNIVERSITY OF ILLINOIS
Chicago  Springfield  Urbana-Champaign

Corporate Credit Card Information

Name as it should appear on the card (limit of 20 characters):

First

Middle

Last

Social Security Number: ______-______-______ Business Phone Number: -

Employee Identification Number (UIN)

Home Phone Number:

-

-

Billing Address:

Street Address (limit of 20 characters)

City

State

Zip

Home Address (Required - If different than billing address):

Street Address

City

State

Zip

Should you have any questions or concerns, please contact Stephen Wiggs at 217-244-4684 or swiggs@uillinois.edu .

Forward completed application to:

Stephen Wiggs OBFS-Corporate Card Office 271 Henry Admin Bldg (M/C-341) 506 S Wright St Urbana, IL 61801

Rev – June 2005