Procurement PCard Protective Suspension Request

This form is to request temporary pcard suspensions due to medical/family leave. If requesting a pcard be permanently closed, please submit a PCard Account Closure Request.
Department Name *
Cardholder Name Cardholder Name * First Last
Cardholder Email *
PCard Approver/Reviewer Name PCard Approver/Reviewer Name First Last
Approver/Reviewer Email *
Protective Suspension Begin Date Protective Suspension Begin Date / MM / DD YYYY
Anticipated Return Date Anticipated Return Date / MM / DD YYYY
Additional Comments (optional)