15. Will any other departments, software packages or outside vendors be involved in the processing of credit card payments? If so, please identify all parties and describe their roles and responsibilities. Yes No Roles/Responsibilities: Signatures: Signatures: ______________________________ __________________________ Merchant Dept Representative Department Head Printed By signing this form, the Merchant Department Representative acknowledges that he/she understands his/her role as outlined in the Tyler policy for Accepting Credit Card and “UT Electronic Payments” and accepts the responsibility of that role. By signing this form, the Department Head approves of the business case presented for the department to become a Merchant Department, the information provided and the designated Merchant Department Representative. Please submit completed form to the Vice President for Administration: Administration Building, ADM 336. Approved By: ___________________________________ Date: _________________ Vice President for Administration When required signatures have been obtained, please forward the original application to Financial Services, Cash Manager. For Financial Services Use Only: Date Received: Application Complete Processed By: Authorized Signature/Date
15. Will any other departments, software packages or outside vendors be involved in the processing of credit card payments? If so, please identify all parties and describe their roles and responsibilities. Yes No Roles/Responsibilities: Signatures: Signatures: ______________________________ __________________________ Merchant Dept Representative Department Head Printed By signing this form, the Merchant Department Representative acknowledges that he/she understands his/her role as outlined in the “UT Tyler policy for Accepting Credit Card and Electronic Payments” and accepts the responsibility of that role. By signing this form, the Department Head approves of the business case presented for the department to become a Merchant Department, the information provided and the designated Merchant Department Representative. Please submit completed form to the Vice President for Administration: Administration Building, ADM 336. Approved By: ___________________________________ Date: _________________ Vice President for Administration When required signatures have been obtained, please forward the original application to Financial Services, Cash Manager. For Financial Services Use Only: Date Received: Application Complete Processed By: Authorized Signature/Date
Merchant-Department-Application.docx