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EMPLOYEES OR STUDENTSEmployee ID or Student ID VENDORSVendor ID

REQUIRED for Employees/Students REQUIRED for Vendors

CHECK DISTRIBUTION INSTRUCTIONS: Date Required ___ ☐ Mail ☐ Mail with Attachment(s) ☐ Pick-Up: Call ___ x

○Mail ○Mail with Attachment(s) ○Pick-Up: Call ___x___

PLEASE TYPE OR PRINT LEGIBLY

1. Contact Name Contact Phone

2. CHECK INFO Name

Address 1

Address 2

City State Zip

3. PURPOSE
4. FOAP & AMOUNT Index (6 digits) Fund (6 digits) Organization (6 digits) Account Code (6 digits) Program (4 digits) Amount

TOTAL

5. APPROVALS Requester Print Name Signature Date

Account Administrator Print Name Signature Date

Account Administrator (if multiple funds or organizations) Print Name Signature Date

Account Administrator (if multiple funds or organizations) Print Name Signature Date

Vice President (required if TOTAL > $19,999.99); VP or ASVP of Student Affairs required for all student organizations.\nPrint Name Signature Date

President (required if TOTAL > $39,999.99)\nPrint Name Signature Date

SUBMIT ORIGINAL TO ACCOUNTS PAYABLE WITH REQUIRED SUPPORTING DOCUMENTATION. TO ENSURE PROMPT

SUBMIT ORIGINAL TO ACCOUNTS PAYABLE WITH REQUIRED SUPPORTING DOCUMENTATION. TO ENSURE PROMPT PAYMENT, COMPLETE ENTIRE FORM AND OBTAIN NECESSARY SIGNATURES. ALLOW 3-5 DAYS FOR PROCESSING.