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Legislative Assembly for the ACT: 1996 Week 11 Hansard (26 September) . . Page.. 3593 ..


The Assistant Under Treasurer ATTACHMENT A
Financial Services

ACT Treasury

APPLICATION FOR ACT GOVERNMENT CREDIT CARD FACILITIES
Please arrange for the issue of an ACT Government Corporate Credit Card

to........................................................................... (Proposed Card Holder)

whose signature follows herewith:..........................................................................

The State Bank "Credit Card Cardholder Request" duly completed is attached herewith
for your attention.

The Credit Card facilities are required for the purchase of the following types of supplies..................................................................................................................

...............................................................................................................................

2. Calculated on the basis of two months transactions the monthly card limit recommended
for the above Cardholder is $.....................

3. Details relevant to the proposed Cardholder are as follows:

Surname:....................................................................................................Mr/Mrs/Ms/Miss

Given Names:........................................................................................................................

AGS No..................................... Position No..........................................

Classification (ASO/CSO etc Level)......................................................................................

Title of Position:....................................................................................................................

Telephone No.................... Location (Building/Floor)................................................

Section................................................. Branch...............................................................

Department............................................................................................................................

4. Details of the proposed Cardholder's Supervisor for purposes of verifying the Cardholder's
monthly reconciliation of Credit Card transactions are as follows:

Surname:.....................................................................................................Mr/Mrs/Ms/Miss

Given Names (in full):............................................................................................................

Position No............................................Classification (ASO/CSO etc Level)...........................

Title of Position:......................................................................Telephone No..........................

Section................................................................Branch.........................................................

Location of Supervisor (Building/Floor)..................................................................................

Above proposed Cardholder Nomination Approved

Nominated by (To be signed by Branch/Agency Head,

or Director)

............................................... .................................................

(Signature) Title..........................................

Name:..................................... Name:.......................................

Section.................................... Branch/Section..........................

Branch.................................... Date...........................................

Date........................................


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