Financial Affairs

Citibank® Government Cards Cardholder Dispute Form

Description: Used to dispute transaction discrepancies for Procard or travel card (TAC or CLIBA card) related purchases.

Last Revised On: 09/01/2011

Owner/Host: Procard/Travel Card Administration (PTCA)

Download File: PDF

Related Forms/Worksheets:

• Business Expense Form (BEF)
• Texas Sales and Use Tax Exemption Certification (Tax Exempt Certificate)
• Procard Transaction Log
• Card Maintenance Request (CMR)
• Procurement Card (Procard) Application and Agreement
• Citibank® Affidavit of Unauthorized Use

Related Financial Management Operational Guideline(s) (FMOG):

• Procard Program
• Travel Cards
• Business Related Hospitality and Entertainment Expenditures

Revision History:

• 06/19/2012: Added existing Citibank form to website (form revised on 09/01/11).

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