Instructions for Completing the
JMU Request for Temporary Payment Card Terminal form

Contact Name:   Person making the request

Date:   Current date

Office or Department:   Name of department making the request

Phone:   Phone number of the person making the request

Email Address:   JMU email address of the person making the request

Fax:   Fax number of the person making the request

• Check yes if you have received written permission from the AVP, Finance for the Business Activity. Check no if you have not received written permission from the AVP, Finance. Complete and attach a Business Activity Synopsis. See University Policy #4501.
• Check the items that you currently wish to take funds for. Check all that apply.
• Check the groups that you will target. Check all that apply.
• Indicate dates terminal will be needed.
• Check yes if the department is interested in taking payments online. Check no if the department is not interested in taking payments online.
• * Location of Payment Card Terminal:   Physical location where the terminal will be located
  * Average Ticket Sale:   Average cost of the registration, item, service, etc. that you are collecting funds for.
  * Approximate Yearly Sales Figure:   Provide an approximate figure for total sales generated in one year
  * Department Id for Deposits:   Provide the dept id for which the fund will be deposited
  * Account Code:   Provide the account code for which the funds will be deposited.