Route this form to:
Ofc of Investments and Banking
145 U Office Plaza oib@umn.edu
U Wide Form:
UM 1798
Rev: Sept 2014
The cards are Visa branded, and may be used at any retailer that accepts Visa as a form of payment.
**BEFORE ordering please read Important information on page 2**
Return the completed form to the Office of Investments and Banking at oib@umn.edu
Department Name: Date:
Requester Name:
E-mail Address:
Campus Address:
Phone:
Fax:
Mailing Address:
Target Date Neededrequires a minimum of 10 business days for receipt
If Rush Order [less than 10 days] dept. may incur additional charges
Date:
GIFT/REWARD CARDS REQUESTED
Indicate card design requested by checking box below
(NOTE: If order is a RUSH order [less than 6 business days], the Red card design is the only option)
Compass card Red card Thank you card Snowy pines card Silver Snowflake card
# of Cards $ Value Amt. of Card Cost calculation Total cost of Cards
# cards x Amt. per card
# cards x Amt. per card
# cards x Amt. per card
Grand Total of Gift/Reward Card Order
**MAKE SURE BUDGET IS SET UP AND HAS ADEQUATE FUNDS BEFORE ORDERING CARDS**
FUND DEPT ID Program Project Account CF1 CF2 Empl ID
Campus Location: East Bank/St. Paul (TC) Duluth Crookston Morris
Purpose/Justification for Request (please describe in detail)
Dept. Approver / PI Signature **(An APPROVAL
Signature is REQUIRED for order)**
Please PRINT Approver Name
The University of Minnesota is an equal opportunity educator & employer.
 2009 by the Regents of the University of Minnesota.
Date
Page 1 of 3

Route this form to:
Ofc of Investments and Banking
145 U Office Plaza oib@umn.edu
U Wide Form:
UM 1798
Rev: Sept 2014
The University of Minnesota is an equal opportunity educator & employer.
 2009 by the Regents of the University of Minnesota.
Page 2 of 3

Route this form to:
Ofc of Investments and Banking
145 U Office Plaza oib@umn.edu
U Wide Form:
UM 1798
Rev: Sept 2014
While most recipients will use the card shortly upon receipt, we do not want departments holding cards for a long period of time. We can order and receive the cards relatively quick, so only order what you need and are going to use within two months at most. Recipients should be reminded to use the Card within 12 months of card order date to avoid any fees.
Gift/Reward Cards arrive active and ready to use . Place your order shortly before you plan to distribute the card(s). This will give the Rewards Card recipient(s) more time to use the card before they are charged a monthly fee*(see below).
*U.S. Bank Gift/Rewards Visa Card Fees & Information ( Effective 8/01/2010)
There are no fees when using the Card to purchase goods and services. The following fees will apply and will be deducted from the balance available on the Card:
Administrative Fee: After the first twelve calendar months following the issue date of your Gift/Rewards
Card , a $2.50 fee will be charged to your Card each month until the card expires. This fee will not be charged once the balance on the Card reaches $0.00.
Telephone & Web Service Fee: You have unlimited free access to balance and account information online at www.myusbankmycorporaterewards.com
.
Phone calls: Your first two unassisted calls to their automated telephone banking number (866-466-8099) are free. Your Card will be charged $.50 for each subsequent call to the automated number. A $1.00 fee will be charged to your Card for all calls routed to a live customer service representative.
Card Replacement Fee: A $15.00 fee will be charged to your Card if it is replaced at any time before expiration, or escheated according to applicable law.
No Resale or Transfer: Sale or transfer of Cards is strictly prohibited.
Expiration, Revocation: The Card is valid through the expiration date shown on the front of the card or until the value on the Card reaches zero, except where prohibited or modified by applicable law.
When the Card expires it will be closed and any unused balance will be handled according to escheat law. Your Card is not redeemable for cash. U.S. Bank may revoke the Card at any time without cause or notice. You must surrender a revoked Card and may not use it to make purchases. You may not sell your Card and U.S. Bank is not liable for the revocation of funds on Cards that have been sold or transferred by you. For the most recent, complete terms and conditions, see the “U.S. Bank Rewards Visa Card Cardholder Agreement” available at www.myusbankcorporaterewards.com.
The University of Minnesota is an equal opportunity educator & employer.
 2009 by the Regents of the University of Minnesota.
Page 3 of 3