University of Virginia -- Procurement Services

Purchasing Unit Request Form
(Revision Date: 04/11/07)

* Required Field

Note: This form is used only for a Purchasing Unit with responsibility for ordering and/or invoice processing -- NOT FOR DELIVERY LOCATIONS. Confused?

Make this change effective on date * (MM/DD/YYYY)

Action Requested, Select One *

I am ESTABLISHING A NEW BUSINESS UNIT responsible for all ordering and/or invoice processing.
-- Justification for New Request:
This is my department's first Purchasing Unit, OR
My department already has at least one other Purchasing Unit Code (PUC). It is

I am UPDATING the information for existing Purchasing Unit

I am CLOSING an existing Purchasing Unit
Deactivate all Delivery Locations associated with this Purchasing Unit, OR
Transfer all Delivery Locations associated with this Purchasing Unit to PUC

Business Unit Information For updates, please enter only fields that are changing -- there is no need to type fields that will stay the same.
For adds, * indicates a required field.

Some default values are provided. Simply type over them if they are not correct.

Department Name:	*
Business Unit Within Department:	*
PTAEO Organization Number:	*

Business Unit's Fiscal Administrator

Name:	*	Phone:	- - *
E-mail Address: @ *

Purchasing Unit Information

Complete Mailing Address for Invoices:	*
City: * State: * Zip: *

Purchasing Unit Contact: (Check if same as Fiscal Administrator above ; otherwise provide all information.)
Name:	Phone:	- -
E-mail Address: @

Requested with Permission of Department Head

Name:	*	Phone:	- - *
E-mail Address:	@ *

Submitted by

E-mail Address (Please do not use alias)
UVA Computing ID: @ *
(Confirming E-mail will be sent to this address.)

University of Virginia -- Procurement Services

Purchasing Unit Request Form(Revision Date: 04/11/07)

Purchasing Unit Request Form
(Revision Date: 04/11/07)