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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 # Location:

Home Services Kmart Sears FLS Hardware


Business
(Circle One) SLS TGI Sears Essentials Outlet

Contract Sales Home Office NY Design Office

Travel & Home Services Home Services Quality Maint.


Card Type Entertainment (Technician) (Other) Technician
(Circle One)
Procurement
(Purchase)
Name of Business for Procurement application

Operations General
Sears FLS Only: Does your store have an Operations Manager? Yes / No
Manager Manager

Cardholder Information

Cardholder

Address

City State Zip Code

Social Security Number (LAST 5 Digits) -

SHC Employee ID Number

Date of Birth / /

Activation Password (4 char)

Work Phone ( ) - Cardholder Email ID @ .com

Manager Name Phone No. ( ) -

Manager Email ID @ .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: Printed


(Signature) Name: Date:

One Card Support Only


Credit Single MCC
Limit (CSL) Purchase Limit Blocking

Hierarchy:
One Card Application Form - Updated November 2009

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