Sears Holdings 1card Application Nov2009

SEARS HOLDINGS ONE CARD APPLICATION ALL FIELDS REQUIRED; FAX COMPLETED APPLICATIONS TO (214)706-5942 ***** INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED***** Profile Information PeopleSoft Overhead #

Business (Circle One)

Location:

Home Services

Kmart

Sears FLS

Hardware

SLS

TGI

Sears Essentials

Outlet

Contract Sales

Home Office

NY Design Office

Travel & Entertainment

Card Type (Circle One)

Home Services (Technician)

Home Services (Other)

Quality Maint. Technician

Procurement (Purchase) Name of Business for Procurement application

Sears FLS Only:

Operations Manager

General Manager

Does your store have an Operations Manager? Yes / No

Cardholder Information Cardholder Address City

State

Social Security Number (LAST 5 Digits)

Zip Code

-

SHC Employee ID Number

/

Date of Birth

/

Activation Password (4 char) Work Phone

(

)

-

Manager Name Manager Email ID

@

Cardholder Email ID Phone No.

@

(

)

.com -

.com

Cardholder Approvals The Cardholder agrees to follow Sears Holdings Corporation policies and procedures for use of company funds, which is restricted to business expenses only, and to provide accurate reporting, as required by Sears Holdings Corporation Cardholder Signature:

Date:

Approved By: (Signature)

Printed Name:

Date:

One Card Support Only Credit Limit (CSL)

Single Purchase Limit

MCC Blocking

Hierarchy: One Card Application Form - Updated November 2009