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Cardholder Forms

Below are forms available for BruinCard holders

These forms provide access to service for BruinCard holders. If you are looking for departmental services, review the UCLA Department Forms Page.

Payroll Deductions

Enroll, adjust or cancel your payroll deduction, where funds are automatically deducted from your paycheck into your BruinCard.

Access Form

Refund Request

Those who have separated from the University may request a refund of remaining BruinCard funds from a personal deposit.

Access Form

Product and Service Fee List

View the BruinCard office’s current fees for card and campus services.

Access Form

BruinCard Door Pin Update

For employees who use keypad access for specific BruinCard doors. For a first-time PIN please contact us.

Access Form

Terms & Conditions

Policy for BruinCard use and services that all cardholders agree to upon receipt of card.

Access Form

BruinCard Image Policy

Policy for BruinCard image use and services that all cardholders agree to upon photo submission.

Access Form