GTC Application Process
GTC Application Process
GTC Application Process
NOTE: You will be asked if you consent to a credit check. If your credit score is below 660, decline the credit
check. You will receive a restricted card instead. If you accept the credit check and your score is below the
660, you will be ineligible for a GTCC for 2 years.
Government Travel Charge Card Information Sheet
ODTA signature___________________________
1.
NAME: LAST, FIRST, Ml FOR SB USE ONLY
PP INIT DATE._________
2.
ENT TO SUPER DATE _______
SSN:
ENT TO APC DATE
3. ___________________ CCOUNT OPEN DATE _______
DOB: MM/DD/YYYY:
th HL.____________
4. I 7500/650 4000/350
RANK/PAY GRADE:
RANS DATE
7. ___________________...__________________.
ENTERPRISE E-MAIL ADDRESS
City:
State: Zip Code:
10. Will GTCC require expedited service ($20.00 fee) Circle & lnitinl: YES NO NA
Signature: _______________ __
Date:
DEPARTMENT OF DEFENSE (DoD)
STATEMENT OF UNDERSTANDING
GOVERNMENT TRAVEL CHARGE CARD PROGRAM
The Government Travel Charge Card (GTCC) is mandated to be used by DoD personnel to pay for authorized
expenses when on official travel unless an exemption is granted. This includes temporary duty travel (TOY),
and, per Component guidance, permanent change of station (PCS) travel.
Signature Signature
Date Date
I, [print name] _________, have received, read, and understand the information regarding
appropriate use of the Government contractor-issued travel charge card. In addition to this agreement, the
specific documents that I have received include: a memorandum to All Employees on "Use of Government
travel Charge Card for Permanent Change of Station (PCS) Expenses," Travel Card Do's and Don'ts for
Employees (booklet} and the Individual Cardholder Agreement from the card issuer.
My failure to adhere to the terms of this Agreement and the Individual Cardholder Agreement between Citibank
and myself may be considered misconduct subject to disciplinary and/or adverse actions, up to and including
dismissal from federal service.
In accepting and using my Government-issued travel charge card to pay for travel expenses, I agree to and
accept the terms above governing my use of this card.
Employees are responsible for reading and adhering to the policies and procedures specified in the cardholder
agreement they sign in order to obtain a Government Travel Charge Card. Under the cardholder agreement
currently in effect, the travel charge card bill is due and payable in full when delivered at the employee's billing
address.
The Employee is liable to Citibank for full reimbursement of all charges authorized by the employee.
Under FTR 301-52.24, Employees must pay amounts owed to the travel card bank in accordance with the
cardholder agreement, even if the employee has not yet been reimbursed for those expenses appearing on the
billing statement.
SIGNATURE: ___________
NAME: ___________
RANK: ____________
DATE: ____________