CHECK REQUEST
PAY TO:
DATE REQUESTED:
DATE REQUIRED:
ADDRESS:
REQUESTED BY:
DISTRIBUTION:
Campus Mail
(check one)
Pick up
U.S. Mail
PLEASE CHECK ALL THAT APPLY:
Invoice/Receipt Attached
Honorarium/Award/Internship
Advance/Prepaid Order
IRS Form W-9 Attached
W9 on File
EXPENSE DESCRIPTION (Describe business, academic and/or research purpose):
Please attach required receipts, invoices, contracts or other supporting documentation.**
General ledger account number(s):
Amount
Approval: Department/Budget Unit Head*
Approval Business Office
Total Amount
of Check
Additional Approval (if necessary) *_________________________
* Requests over $20,000 also require the approval of the Vice President of Finance and
Administration, the Provost or the President.
** Requests without description and appropriate supporting documentation may be returned.