HTML Preview Bank Wells Fargo Application Form page number 1.
WELLS FARGO ONE CARD PROGRAM
CARD ACCOUNT APPLICATION AND MAINTENANCE FORM
INSTRUCTIONS FOR COMPLETING THIS FORM
PLEASE TYPE FORM, EXCEPT SIGNATURES
SECTION 1
Type of request: Please select one option and complete fields as necessary. Please note that all accounts must
have an Executive Director or higher level of approval.
1.1 New Account: Regular or Declining Balance
Regular - A regular VISA card is issued with a monthly credit balance that renews at the close of every
billing cycle.
Declining Balance Card - A VISA card is issued with a maximum amount that may be spent within a
specific time period. The amount does not renew at the close of each monthly cycle. Once the ending
date arrives or the amount is used, the card is closed. These would typically be used in place of a cash
advance.
1.2 Change to Account - this would apply to any change to the application (reconciler, approver,
secondary approver, credit limit, account number)
1.3 Account Closure - When a cardholder is no longer with the University. Please turn in credit
card to Human Resources. They will then notify Accounts Payable regarding the account
closure.
SECTION 2
2.1 If box 1.2 was marked in Section 1, please fill in last 8 digits of credit card information.
2.2 If box 1.2 was marked in Section 1, please fill in name as shown on credit card.
SECTION 3
3.1 Name to appear on card: Please give name as it appears on your identification card used
for verification.
3.2 Email address: Preferably an APU email address but should be the address to where you frequently
review your emails. All correspondence from Accounts Payable and Wells Fargo will be sent to you
via email including monthly statement notification.
3.3 Job title: Current position title at APU.
3.4 Last 5 digits of Social Security Number: Required by Wells Fargo as verification on your account.
3.5 Department Name: Please give your current department name
3.6 Department account #: 7 digits required only (fund & department) if account starts with 15 or 16, please
Add 5 digit project number.
3.7 Reconciler name/email/SS#: You may choose your administrative assistant or other employee to
serve as the person to reconcile your monthly statement on-line. Otherwise, you will be the only
person allowed to access and reconcile your statement on a monthly basis. Both the cardholder and
reconciler will have access to the account.
Please complete the "Reason for Request" for the Wells Fargo One Card Program on the application.
Forms received without this information will be returned.