P: 412-268-8186-2026

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Click ‘Get Form’ to open it in the editor.
Begin with Section A: Payment Information. Enter the Charge GL and Charge GM numbers as required. Ensure that you fill in all necessary fields accurately.
Next, provide the Authorizing Name and Phone Number in Section A. This information is crucial for processing your request.
Move to Section B for the Departmental Print & Copy Card Request. Specify the Card Value and Quantity needed for your department's printing needs.
In Section C, if applicable, fill out the Student Name, Student Andrew ID, Student ID Card Number, and Deposit Amount for Plaid Cash deposits.
Finally, complete Section D by providing the name of the person picking up the card and their signature. Make sure to include the date before submission.
Once completed, return this form to The HUB at Warner Hall A12 for processing.

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