"Welfare/Offender Trust Fund Withdrawal Request Form" - Florida

This "Welfare/Offender Trust Fund Withdrawal Request Form" is a Florida-specific form released by the Florida Department of Juvenile Justice on April 1, 2005.

Download the form by clicking the link below, fill it out by hand, and mail it as per the guidelines provided by the department or the applicable legal instructions.

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Download "Welfare/Offender Trust Fund Withdrawal Request Form" - Florida

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DEPARTMENT OF JUVENILE JUSTICE
WELFARE/OFFENDER TRUST FUND WITHDRAWAL REQUEST
TO:
DEPARTMENT OF JUVENILE JUSTICE
BUREAU OF FINANCE AND ACCOUNTING
2737 CENTERVIEW DRIVE
TALLAHASSEE, FLORIDA 32399-3100
FROM:
OFFICE/FACILITY NAME:
ORG CODE:
EO:
WF
REQUESTED AMOUNT:$
MAKE CHECK PAYABLE TO:
MAIL CHECK TO:
DESCRIPTION/JUSTIFICATION OF EXPENDITURES:
THIS IS TO CERTIFY THAT I UNDERSTAND I MUST SUBMIT RECEIPTS AND/OR A MONEY
ORDER/CASHIER'S CHECK EQUAL TO THE REQUESTED AMOUNT TO THE BUREAU OF
FINANCE AND ACCOUNTING WITHIN 10 WORKING DAYS FROM THE ISSUANCE DATE OF
CHECK.
REQUESTOR:
TITLE:
SUNCOM:
DATE:
DJJ DIRECTOR/MANAGER OR DESIGNEE APPROVAL:
SUNCOM:
DATE:
FOR FINANCE AND ACCOUNTING USE ONLY:
CHECK NUMBER:
APPROVED BY:
TITLE:
DATE:
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Revised 4/05
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DEPARTMENT OF JUVENILE JUSTICE
WELFARE/OFFENDER TRUST FUND WITHDRAWAL REQUEST
TO:
DEPARTMENT OF JUVENILE JUSTICE
BUREAU OF FINANCE AND ACCOUNTING
2737 CENTERVIEW DRIVE
TALLAHASSEE, FLORIDA 32399-3100
FROM:
OFFICE/FACILITY NAME:
ORG CODE:
EO:
WF
REQUESTED AMOUNT:$
MAKE CHECK PAYABLE TO:
MAIL CHECK TO:
DESCRIPTION/JUSTIFICATION OF EXPENDITURES:
THIS IS TO CERTIFY THAT I UNDERSTAND I MUST SUBMIT RECEIPTS AND/OR A MONEY
ORDER/CASHIER'S CHECK EQUAL TO THE REQUESTED AMOUNT TO THE BUREAU OF
FINANCE AND ACCOUNTING WITHIN 10 WORKING DAYS FROM THE ISSUANCE DATE OF
CHECK.
REQUESTOR:
TITLE:
SUNCOM:
DATE:
DJJ DIRECTOR/MANAGER OR DESIGNEE APPROVAL:
SUNCOM:
DATE:
FOR FINANCE AND ACCOUNTING USE ONLY:
CHECK NUMBER:
APPROVED BY:
TITLE:
DATE:
Save As
Print
Revised 4/05
Reset/Clear Form
Email Form
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