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AUTHORIZATION FOR THE PURCHASE OF GIFT CARDS/GIFT CERTIFICATES USING GRANT FUNDS

Instructions for Completing the Gift Card Authorization Form
1. This form must be completed and receive approval before purchasing any gift cards/gift certificates.
2. Attach Approved Form to ESM Requests and Reimbursements: If you are submitting an ESM request or reimbursement, include a copy of the approved authorization form. Requests without the form will be rejected.
3. For Credit Card Purchases: If you're using a university Wells Fargo credit card to buy gift cards, a copy of the completed Authorization Form must be included with the credit card statement reconciliation.
4. An authorized signature is required before purchasing gift cards or gift certificates. This form will be automatically submitted for approval. The approval or denial will be sent to the requester via email, with an expected processing time of two days.

5. Maintain Records: Keep the completed Authorization Form(s) along with the Gift Card Log in your department, following the policy guidelines.

Purchaser's Information

Purchaser’s Name:

Purchaser’s Department:

Purchaser's email:

Principal Investigator (PI) or (PD) Name:

Grant Title:

Purchaser's signature

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Purchase Information
**Note: Prepaid Visa/MC/Amex cards typically include activation fees. Please include this with your costs.

Vendor Name (Entity from which Cards are to be purchased):

Qty:

Cost per Unit/Card:

Total Amount:

Est. Date of Purchase:

Month/Year of Disbursement:

Description of Intended Use of Cards (e.g., drawing, incentive or prize, student recognition):

Intended Payment Method

Kean Credit Card
Employee Reimbursement
Purchase Order

Cost Center to be Charged:

Fund

Cost Center

Object Code

An authorized signature is required before purchasing gift cards or gift certificates. This form will be automatically submitted for approval. The approval or denial will be sent to the purchaser via email, with an expected processing time of two days.

Office of Research and Sponsored Programs (ORSP):

VP of Research Signature/ Grant Administrator Signature:

Print Name:

Date:
Approve:
Deny: