Account Closure Request Account Closure Request Requester Name * Requester Name First First Last Last Requester UNID# * Requester's Relationship to Cardholder(s) * Cardholder Cardholder's Supervisor Account Executive Reallocator OtherOther Cardholder Information Click “Add” at the bottom of this section to process more than one Cardholder. You can add as many as needed. Cardholder's Name * Cardholder's Name First First Last Last Cardholder's UNID# * Last 10 Digits of Card # * Final Statement Recipient * Final Statement Recipient First First Last Last Final Statement Recipient UNID# * *This final statement recipient should be someone in the PCard holder’s department who will manage or maintain records. This cannot be the cardholder – and cannot be left blank. plus1 Add minus1 Remove Certification * I certify that I am authorized to make this request by either the cardholder, or the cardholder’s supervisor and/or from the Account Executive or someone else authorized in Granting Financial Authority (GFA) for the cardholder’s default Chartfield(s). Certification * I understand once this form is received/processed, the PCard will be closed in the bank. This action is final and the account cannot be reopened. This card will be available in the reallocation system for up to two months to allow for final processing. Certification * I will shred the PCard(s) after submitting this form. Signature * signature keyboard Clear Email a Copy of This Completed Form? Don't Send Send Email If you are human, leave this field blank. Submit Δ
