Form OTECH 110 Processing Credit Request - California

Form OTECH110 or the "Processing Credit Request" is a form issued by the California Department of Technology.

The form was last revised in July 1, 2013 and is available for digital filing. Download an up-to-date Form OTECH110 in PDF-format down below or look it up on the California Department of Technology Forms website.

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STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF TECHNOLOGY
OFFICE OF TECHNOLOGY SERVICES
PROCESSING CREDIT REQUEST
OTECH 110 (REV. 07/2013)
OFFICE OF TECHNOLOGY SERVICES
USE ONLY
DEPARTMENT
DATE
NAME
PHONE NUMBER
OTECH CUSTOMER RELATIONS REPRESENTATIVE
CALNET
JOB NAME
JOB NUMBER
PROCESS DATE
AMOUNT OF CREDIT, IF KNOWN
OTECH ACCT. CODE
IAA NUMBER
DESCRIPTION OF ERROR
USE REVERSE SIDE OF FORM IF NECESSARY. INCLUDE ALL REQUIRED DOCUMENTATION.
OFFICE OF TECHNOLOGY SERVICES USE ONLY
COMMENTS
JOB COST
SIGNATURE
DATE
DISPOSITION
APPROVED AS REQUESTED
NEGOTIATED CREDIT APPROVED
PARTIAL CREDIT APPROVED
CREDIT APPROVED
REVIEWER'S COMMENTS
Fiscal Use Only
Account Number
Amount to be Credited
$
SIGNATURE
DATE
STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF TECHNOLOGY
OFFICE OF TECHNOLOGY SERVICES
PROCESSING CREDIT REQUEST
OTECH 110 (REV. 07/2013)
OFFICE OF TECHNOLOGY SERVICES
USE ONLY
DEPARTMENT
DATE
NAME
PHONE NUMBER
OTECH CUSTOMER RELATIONS REPRESENTATIVE
CALNET
JOB NAME
JOB NUMBER
PROCESS DATE
AMOUNT OF CREDIT, IF KNOWN
OTECH ACCT. CODE
IAA NUMBER
DESCRIPTION OF ERROR
USE REVERSE SIDE OF FORM IF NECESSARY. INCLUDE ALL REQUIRED DOCUMENTATION.
OFFICE OF TECHNOLOGY SERVICES USE ONLY
COMMENTS
JOB COST
SIGNATURE
DATE
DISPOSITION
APPROVED AS REQUESTED
NEGOTIATED CREDIT APPROVED
PARTIAL CREDIT APPROVED
CREDIT APPROVED
REVIEWER'S COMMENTS
Fiscal Use Only
Account Number
Amount to be Credited
$
SIGNATURE
DATE

Download Form OTECH 110 Processing Credit Request - California

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