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FSC Procurement Card Purchase Receipt Form

This form must be completed in one sitting and cannot be saved to complete later.

Click here for a guide on using this form��

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Indicates required field

Who is your FSC tech?

Choose your Department/Org # (in 1 of the 3 drop downs)

Dept. Abbreviation/Org. # (A-D)

Dept. Abbreviation/Org. # (E-L)

Dept. Abbreviation/Org. # (M-Z)

Please just choose one department from the lists.

Form completed by

Cardholder Name

Have you uploaded a receipt to Concur?

��Yes

��No

If no, attach ONE itemized receipt per form here

One file only.
32 MB limit.
Allowed types: gif jpg jpeg png bmp eps tif pict txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods xml.

Open for Additional File Upload Fields

First additional file

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20 MB limit.
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Second additional file

One file only.
20 MB limit.
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Third additional file

One file only.
20 MB limit.
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Fourth additional file

One file only.
20 MB limit.
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Fifth additional file

One file only.
20 MB limit.
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Sixth additional file

One file only.
20 MB limit.
Allowed types: gif jpg jpeg png bmp eps tif pict txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods xml.

Speedtype

Amount

Do you need more additional speedtype/amount fields?

��Yes

��No

Is this purchase for food/beverage?

��Yes

��No

If "yes" additional form will load and must be filled out

FSC Documentation for Official Functions

Official Function Attendance

��10 attendees or less

��More than 10 attendees

Section One:

For up to 10 attendees:��list names and relationships, e.g. Chris Jones (faculty member); Mary Doe (employee recruit)

Attendee 1

Attendees relationship to the University

Name

Provide the name for the attendee with the above university relationship

Attendee 2

Attendees relationship to the University

Name

Provide the name for the attendee with the above university relationship

Attendee 3

Attendees relationship to the University

Name

Provide the name for the attendee with the above university relationship

Attendee 4

Attendees relationship to the University

Name

Provide the name for the attendee with the above university relationship

Attendee 5

Attendees relationship to the University

Name

Provide the name for the attendee with the above university relationship

Attendee 6

Attendees relationship to the University

Name

Provide the name for the attendee with the above university relationship

Attendee 7

Attendees relationship to the University

Name

Provide the name for the attendee with the above university relationship

Attendee 8

Attendees relationship to the University

Name

Provide the name for the attendee with the above university relationship

Attendee 9

Attendees relationship to the University

Name

Provide the name for the attendee with the above university relationship

Attendee 10

Attendees relationship to the University

Name

Provide the name for the attendee with the above university relationship

Section Two:

Attendee Totals

Total Number of Attendees

Number of Attendees

Attendee Relationship

Select the relationship of attendees

Number of Attendees

Attendee Relationship

Select the relationship of attendees

Number of Attendees

Attendee Relationship

Select the relationship of attendees

Number of Attendees

Attendee Relationship

Select the relationship of attendees

Number of Attendees

Attendee Relationship

Select the relationship of attendees

Number of Attendees

Attendee Relationship

Select the relationship of attendees

Need more attendee fields?

��Yes

��No

Number of Attendees

Attendee Relationship

Select the relationship of attendees

Number of Attendees

Attendee Relationship

Select the relationship of attendees

Number of Attendees

Attendee Relationship

Select the relationship of attendees

Number of Attendees

Attendee Relationship

Select the relationship of attendees

For more than 10 attendees: list number of individuals and describe the relationship, e.g., students, faculty, staff

An official function is a meeting, meal, or other function that is hosted by an organizational unit, attended by guests and/or associates or employees, and held for official university business. All official functions must comply with the Administrative Policy Statement Propriety of Expenses and the PSC Procedural Statement (PPS) Sensitive Expenses. Please provide all attendees and relationship to the University

Description of items

Description of items

Business Purpose

Business Purpose

Please explain in detail how this expense relates to official University business.

Additional Comments

Email Confirmation

Would you like an emailed copy of this form sent to you?

��Yes

��No

Enter your email address (if multiple, use comma to separate)

Multiple email addresses may be separated by commas. Emails are only sent to cc and bcc addresses if a To email address is provided.