| Form Field | Description |
| Department | Department that submits the request. The department name as it will appear on the customers' statement. Standard format is U of S xxxxxxxx where xxxxxxxx=Dept Name (example: U of S Admissions) |
| Contact | Primary contact person in the department for functional issues. |
| Phone | University telephone number where the person who completed the form can be contacted |
| Campus Address: | Departmental University address. If printer and terminal is the selected method of processing, equipment will be delivered to this address. |
| Fax number: | University fax number where functional information will be sent. This is the fax number that information related to chargebacks will be sent to. |
| E-Mail Address: | Address where information regarding functional issues will be sent. It is recommended
that a group email address be used. (example: SESD@usask.ca) |
| Estimates: | The University payment processor requires information on the expected average value of each transaction and the expected annual number of transactions. A "best guess" estimate is sufficient. |
| UniFi Account: | This is the department's UniFi account number that bank transaction fees and credit card discount charges will be charged to. |
| Method: | Please choose which method of processing credit and/or debit cards is required. Please note that processing debit cards requires a Terminal and Printer. Credit cards may be processed through any of the three options. |
| Authorized Signature: | Signature of the person in the department authorized to incur charges on department's UniFi account |
| Date: | Date form completed and forwarded to Treasury Office. |
| Original | Forward to Treasury Office, Room E40, Administration Building. |
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