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.

Mobile Users

For the best experience in completing this form use a non-mobile device.


  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?

Valerie Dennis.

Valerie Dennis

Asset Management, Card Programs and eProcurement

Financial Management

Phone: 716-645-2604


Form Facts

Form Type: Downloadable, PDF document

Requirements: Adobe Reader

Updated:  10/2022

Owner: Financial Management