Procurement Card (PCard) Order Form for State

Order allowable goods and services from a supplier using your New York State Procurement Card (PCard). You can also use this form to document your transactions.  

Keep This Record

Your department must retain this record and attach original receipts to the back for six (6) years plus the current year.

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  1. Enter your order into the form along with delivery and cardholder information
  2. Get a departmental approval signature if necessary
  3. Fax this form to your supplier
  4. Keep the order form and attach receipts to it

*This form can also be used to record your transactions for audit and tracking purposes, much like the monthly summary log sheet.  

Need Help Completing the Form?

Send email, phone or submit a question

Angie Rzeszut

Angie Rzeszut

Director of Accounts Payable, Travel and Procurement Card

Financial Management

Phone: 716-645-4533


(We'd like to respond to you.)

Form Facts

Form Type: Downloadable, PDF document

Requirements: Adobe Reader

Updated:  08/2014

Owner:  Procurement Services