umsl gift card log & receipts and ppt/new-1.28.19-gift-l… · the gift card recipient should...
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Revised July 27, 2015
UMSL Gift Card Log & ReceiptsControl # (for Accounting use only)
Purchasing Information:MoCode: Department:
Purchased by: Log Submitted by:Card Retailer: Confidential Study:Date Cards Received: OneCard or SMS Requisition #:
Card Serial NumberAmount of
Card Date Card Given Recipient Name (or Subject # if confidential)Empl ID or
Tax IDEmployee
Y/NPermanent Mailing Address
(Complete for Non-Employees)
This form is used to document the gift cards held by the Custodian in accordance with BPM 220. The completed log must be submitted to Campus Accounting monthly (log of all gift cards distributed during one month are due in Campus Accounting by the 7th of the following month).
By entering Purchasing Information , Card Serial Number and Amount of Card in the fields below, prepopulated receipts will be generated on the second tab of this spreadsheet. These receipts should be printed in advance and attached to each gift card prior to disbursement. The gift card recipient should complete this receipt and return it to the department as acknowledgement that the card was received. To ensure confidentiality, only the department should complete the log below. Receipts must be retained in the department in accordance with University Security and Records Retention policies.
If the recipients of the gift cards are research subjects participating in an Institutional Review Board (IRB) approved confidential study, enter the individual's Subject # (in place of their Name, Empl Id or Tax ID, and Address) and do not send this log to Campus Accounting; maintain records in the department.
Revised July 27, 2015
Card Serial NumberAmount of
Card Date Card Given Recipient Name (or Subject # if confidential)Empl ID or
Tax IDEmployee
Y/NPermanent Mailing Address
(Complete for Non-Employees)
Revised July 27, 2015
Card Serial NumberAmount of
Card Date Card Given Recipient Name (or Subject # if confidential)Empl ID or
Tax IDEmployee
Y/NPermanent Mailing Address
(Complete for Non-Employees)
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer) Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer) Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer) Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
0
0
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID /TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID /TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID /TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Gift Card Receipt SMS Req # 0 Gift Card Receipt SMS Req # 0
Card Serial Number 0 Card Serial Number 0
Card Retailer 0 Card Amount -$ Card Retailer 0 Card Amount -$
Employee Y/N Employee Y/N
EMPL ID/TAX ID EMPL ID/TAX ID
Recipient Name Recipient Name
Mailing Address Mailing Address
Signature (Recipient or Mailer)
Date Received/Mailed Date Received/Mailed
Control # 0 Control # 0
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)
Signature (Recipient or Mailer)