G. Pcard Registration Form

							                REGISTERED PROCUREMENT CARD PROGRAM DETAILS
For the purpose of this document, “You” and “Your Company” mean a Staples Contract customer who
has a registered procurement card or is a candidate for our registered procurement card program.)
We are happy that you have chosen to add the benefit of participating in Staples’ Registered Procurement
Card (“Registered P-Card”) Program to your relationship with Staples. The following are conditions
governing your participation in the Staples Registered Procurement Card Program:
Registration –Credit cards will be registered by Staples for use in Staples store locations upon receipt and
approval by Staples Business Advantage (SBA) or Staples National Advantage (SNA), of a completed and
authorized application. The completed application will constitute approval by your Company to register the
P-Card to the individual appearing on the application. In the event that (a) a Registered P-Card is stolen,
(b) your Company no longer desires to participate in the Registered P-Card Program or (c) the individual
appearing on the application is no longer employed by your Company, you or your Company shall provide
Staples with prompt written notice that the Registered P-Card should be unregistered.
Budget Centers - You can attach one budget center number to each Registered P-Card. If this is done, the
budget center number will reflect on the transaction record that’s passed to the Staples Order Management
System. The budget center number may also appear on the individual’s credit card statement, depending on
the level of reporting your Company is receiving.

Purchases – The Registered P-Card may be used to make purchases at any Staples store in the United
States as long as Company maintains a corporate purchasing relationship with SBA or SNA, or an affiliate
of Staples, Inc. Purchases must be made in person at the store and must be taken from the store by the
purchaser at time of purchase. Purchases using the Registered P-Card for Staples.Com purchases or at the
In-Store Kiosk are not inclusive of this program and will not receive the negotiated program pricing. If a
multi-function credit card is registered and used to make the purchase, Staples cannot support the cash back
options as they are not included in this program.

Pricing – Purchases made with the Registered P-Card will reflect the lower of the negotiated program price
or the store price, whichever is lower. On Registered P-Card purchases, the store receipt will indicate the
negotiated program price if applicable. Notwithstanding the foregoing sentence, if Staples’ electronic
pricing system is offline or not operational for any reason, the store receipt will indicate the store prices and
any product savings will appear on your monthly credit card statement only.
Invoicing/Payment – At time of sale, the purchase is treated the same as any other credit card transaction:
Registered P-Card swiped, authorization obtained, customer signs store receipt, and debit transmitted to
Customer’s issuing bank for settlement.
Returns – Returned items purchased with a Registered P-Card must be brought back to a Staples retail store
by the purchaser and the purchase amount will be credited back to the same card as the original purchase.
The credit will appear on customer’s next credit card statement. The original purchase receipt must
accompany all returns.

Tax Exemption – All retail store purchases made using a Registered P-Card will be charged sales tax,
unless the Company (a) provides a valid tax exemption certificate at time of purchase, (b) previously
provided a valid tax exemption certificate at Retail and is in the Host Based Tax Look-up Database, or (c)
the Company shows a valid Retail Tax Exempt ID card along with their Registered P-Card at the time of
purchase.
Registered P-Card Reporting – If the Registered P-Card is registered to a unique bill to and/or ship to, the
Company can request a report at the bill to level only, which will identify all retail Registered P-Card
activity.
Liability – This program is for the convenience of Company as an additional benefit to its Corporate
Purchasing Agreement with SBA or SNA. It is the responsibility of Company to notify the Staples’ Sales
Representative of any lost or stolen Registered P-Card. Authorized persons must confirm any changes,
additions, or deletions to the account information for each Registered P-Card in writing within five (5) days
of such change. Any liability for fraudulent or unauthorized use of the Registered P-Card, including
employee fraud, is the sole responsibility of Company and Company shall be liable to SBA/SNA for any
such purchases until notification is given with respect to any loss or theft.
                    Credit Card Registration Form
                    For Staples Internal Use
     Contract Account Information:

     * Division:                         LA

     * Master Number:                    1619091

     * Company Name:                     WASHINGTON REALTORS CONSORTIUM

     * Billto ID:                        WRCPCRD

     * Shipto ID:                        WRC-PCARD

     *Required information


                             Please type in information below
     Credit Card Information:
     * Card Number:

       Card Holder First Name:

       Middle Initial:

       Card Holder Last Name:

       Email Address:

      *Required information

     Please send your typed completed form to our secure fax
                    machine @ 877-337-8535
The purpose of the application is to register a credit card which can be used for purchases at
Staples Retail store locations. Once registered, you will receive either your Company’s contract
price or the store price, whichever is lower. Please allow 2-3 business days for your card to be
registered and ready for use. The presence of your master account number at the bottom of the
store receipt is an indicator that your card has been registered.

To meet PCI compliance standards, this form will be micro-shredded immediately after
processing.