PeopleSoftFinanceAccessForm Completethisformandhaveitsignedbyyoursupervisor.Faxthiscompletedformto(803) 777-9586. EmployeeContactInformation LastName FirstName Dept.Name Phone Email Campus NetworkID Ineedthefollowingrolestoproperlycompletemyjobtask: RequisitionerRole‐Completeon-linepurchasingrequisitions,paymentrequestandreceiving GeneralLedgerAccountRole–Completejournalentries DepartmentalDepositorRole–DepositmoneywiththeBursar’sOffice Approver Role ‐ Approves requisitions/payment request asApprover 1orApprover2 (CIRCLE THE APPROPRIATE APPROVER)for department(s): , , , Other: Univ.ofSouthCarolina–StatementofUserResponsibility(PolicyACAF7.02) IunderstandthatbyvirtueofmyemploymentwiththeUniversityofSouthCarolina,Imayhaveaccesstodata, information,systems,orfilesinvariousformswhichcontainindividuallyidentifiableinformation,thedisclosure ofwhichmaybeprohibitedbyfederalorstatelaworbyUniversitypolicy.I acknowledgethattheintentional disclosurebymeofthisinformationtoanypersoncouldsubjectmetocriminalandcivilpenaltiesimposedby law. I further acknowledge that such willful or unauthorized disclosure may also violate University of South Carolinapolicyandcouldconstitutejustcausefordisciplinaryactionincludingterminationofmyemployment onthefirstoffenseregardlessofwhethercriminalorcivilpenaltiesareimposed. IfIamindoubtaboutarequest,Iwillconsultwithmysupervisorpriortoreleasingtheinformation. MysignaturedenotesthatIhavereadandunderstandtheabovestatement. SignatureofEmployee Date SignatureofSupervisor Date UNIVERSITY OF SOUTH CAROLINA CONTROLLER’S OFFICE COLUMBIA, SOUTH CAROLINA 29208 803/777-2602 FAX 803/777-9586