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Credit Card Acknowledgment Form

Section 1: Terms and Conditions

Your use of a New York State JP Morgan Chase Travel, Non-Employee Travel (NET) or Procurement Card is subject to the following terms and conditions:
  1. You are being entrusted with a valuable tool - a NYS JP Morgan Chase Travel, NET or Procurement Card. The travel card is to be used for the cardholder’s state business or official government travel expenses only. The NET card is to be used by the cardholder for state business or official government travel expenses for non-employees traveling on behalf of the State.   The purchase card is to be used for State business or official government purchases of services and commodities. Because you will be making a financial commitment on behalf of the State, you must strive to obtain the best value for the State by following established travel or purchasing policies as appropriate.
  2. All charges made to your credit card will be posted to a central bill by JP Morgan Chase and sent to your agency’s Card Program Administrator or designee for payment. You will not receive a bill from JP Morgan Chase (although you are encouraged to view your monthly statement of charges online to identify inaccuracies or fraudulent charges and address them timely). If you have a travel card, it is important that you submit your expense report promptly for all charges to be reconciled. All transactions charged to a State Procurement, Travel or Non-Employee Travel Card must be reconciled in the Statewide Financial system within 30 days of the travel event or purchase. Failure to  reconcile transactions in a timely manner may result in revocation of your State credit card.
  3. You may only use the travel card to pay for your state business or official government travel expenses when you are on official State business. You may only use the procurement card for authorized State business or official government transactions. You may not use this credit card for personal charges. Your agency and the Office of the State Comptroller will audit the use of your card and take appropriate action on any discrepancies or unauthorized charges. Any evidence that your card has been used fraudulently will require an investigation, after which disciplinary action may result. Fraudulent use may also result in criminal prosecution. For Travel card guidelines, please review the following link
  4. You must follow the policies and procedures established by New York State for the use of the procurement credit card. Failure to do so may result in revocation of your user privileges or other disciplinary action, which could include termination of employment. For procurement guidelines, please review the following link
  5. Your Agency will establish spending limits for cardholders. You are responsible for knowing your limits and not exceeding them without approval. In addition, certain purchases from merchants or vendors outside the scope of authorized program guidelines may be blocked by the card.
  6. NYS JP Morgan Chase Travel, NET and Procurement Cards are the property of New York State. You must destroy and cancel your card with JP Morgan immediately upon request or upon termination of employment or retirement. Should there be any change in your employment status you must return this card and arrange to have a new card issued, if necessary.
  7. If this credit card is lost or stolen, you must notify your agency’s Card Program Administrator and JP Morgan Chase immediately. Review of recent transactions within the last 30 days is required to identify any fraudulent charges and appropriate action can be taken.
  8. You must comply with any changes to the terms and conditions or policies and procedures concerning use of this credit card.
  9. You must certify, by entering your name below, that you are not listed on the Office of Foreign Assets Control (OFAC) Specially Designated Nationals and Blocked Persons (SDN) list.
1. I acknowledge that I am the employee or cardholder receiving the card, and that I have read, understand and agree to comply with these terms and conditions and all policies and procedures established for use of the card. *This question is required.
2. Select Credit Card Type (check all that apply) *This question is required.
8. Work Address
9. Do you want your credit card mailed to a different address? *This question is required.
Some agencies allow for home address delivery. Please supply an alternate mailing address for agency consideration.
10. Mailing Address