Bank Wells Fargo Application Form

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PRINT FORM AND EITHER CAMPUS MAIL OR SCAN TO ACCOUNTS PAYABLE AT AccountsPayable apu.edu APPROPRIATE SIGNATURES MUST BE COMPLETED Revised 05/30/17 Please check one Faculty Student Staff Temp Adjunct Print Form Wells Fargo One Card Program Card Account Application and Maintenance Form PLEASE SEE INSTRUCTIONS ON PAGE 2 - ALL ITEMS MUST BE COMPLETED REASON FOR REQUEST: SECTION 1: TYPE OF REQUEST (CHOOSE ONE) 1.1 New Account: (complete section 3, 4 5) Regular Declining Balance 1.2 Change to Account: (complete sections 2 and section 3 or 4 depending on what needs to be changed always section 5 ) reconciler, approver, secondary approver, credit limit, account number 1.3 Account Closure: (please turn in card to Human Resources so they can amend their records) SECTION 2: FOR CHANGES TO CURRENT ACCOUNTS ONLY: 2.1 Fill in last 8 digits of card account number: 2.2 Fill in current name on card: SECTION 3: CARDHOLDER APPROVER INFORMATION 3.1 Name to Appear on card 3.2 Email address 3.3 Job Title 3.4 Last 5 digits of SS Number 3.5 Department Name 3.6 Department Number 3.7 Reconciler Name/Email addr./Last 5 digits of SSN 3.8 Approver Name/Email addr./Last 5 digits of SSN 3.9 Secondary Approver Name/Email addr./Last 5 digits of SSN (Secondary approver required) SECTION 4: CREDIT LIMITS (if you need other limitations, please contact Accounts Payable 4.1 Regular Card Monthly Cr..