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Legislative Assembly for the ACT: 1996 Week 11 Hansard (26 September) . . Page.. 3595 ..

ATTACHMENT C

RECORD OF PURCHASE THROUGH CREDIT CARD USAGE
NO ........

DEPARTMENT.................................................................................DIVISION.......................................

BRANCH/SECTION..................................................................................................................................

CARDHOLDER'S NAME.........................................................................................................................

TRANSACTION LIMIT $.....................................................CREDIT CARD LIMIT $............................

BULK REQUISITION NO........................................................................................

AVAILABLE LIMIT AS AT DATE..........................................................................

PURCHASES ARE RESTRICTED TO THE FOLLOWING CATEGORIES OF

SUPPLIES:................................................................................................................................................

SUPPLIER: STATE BANK - CREDITCARD SETTLEMENT ACCOUNT

NO. 10204400

SUPPLIER (FISCAL) CODE NO:....................................................

QUOTATIONS:

Quotation obtained from Phone No Date Cost

1................................................................................................................................................................

2................................................................................................................................................................

3................................................................................................................................................................

PURCHASE DETAILS:

Quantity Cost Description Charge Code No & Description

ABOVE PURCHASE EFFECTED:

1) At request of .........................................................

2) Title of officer........................................................

3) Location.................................................................

4) Phone No...............................................................

5) Date.......................................................................

PURCHASE AUTHORISED BY:

Signature:..................................................................

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

Title:..........................................................................

Position No:..............................

Date:.........................................

FULFILLED ORDER/SERVICES HANDOVER/PROVIDED TO..........................................................

SIGNATURE OF RECIPIENT OFFICER:.................................................................................................

DATE....................................................

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