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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

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\nPrint Name	Signature			Date
	Account Administrator\nPrint Name	Signature			Date
	Account Administrator (if multiple funds or organizations)\nPrint Name	Signature			Date
	Account Administrator (if multiple funds or organizations)\nPrint Name	Signature			Date
	Vice President (required if TOTAL > 19,999.99); VP or ASVP of Student Affairs required for all student organizations.nPrint Name < /td > < td colspan = "3" > Signature < /td > < td colspan = "2" > Date < /td > < /tr > < tr > < td style = 'text-align: center; word-wrap: break-word;' > President (required if TOTAL gt;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.