Request to Increase Copy Card Value

You can not submit this form electronically.  Fill in each blank on-line, print it out, obtain an authorization signature, and mail  the form to the Copier Office.  Do not send cards.

Department Name                 

Account Number                 

Contact Name                        Phone #    

  • List the number off of the front of the card.
  • Fill in the # of copies you want to add to each card . Funds will be deposited into the copier account unless you indicate the funds should be deposited into the print lab account.

    • Card Number     Copies to Add                For

             #                

             #                   

             #                   

             #                   

             #                   

             #                   

             #                   

             #                   

                      

    Authorization Signature ________________________________  Date ____________________

    This is not a invoice.  This information will be used to generate an invoice to be sent to Accounts Payable for billing purposes.  A copy of the invoice will be mailed to you.