"Wpi Check Request Form"

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WPI CHECK REQUEST
(Send to Accounts Payable)
Payable to:
For Accounting Use Only
Banner ID #/Vendor #:
Seq #:
Due:
Remit to address:
Doc #:
Document Accounting "Off"
Title To:
FG
/
SR
/
LS
/
WPI
1099:
Y / N
SPECIAL HANDLING INSTRUCTIONS (Enter "X")
Indicate if Credit Memo:
(Must be on a separate request)
Mail with enclosure
Send to WPI Box
Send to Dept. _____________
Call ____________________ @ ext.________ for pickup
Purpose/Description
Accounting Use Only
Asset Type
Attach the following:
Original Invoice
Purchase Order (copy)
Packing Slip (copy)
WPI Vendor Justification Form
(for purchase $10,000 and over)
FABRICATION
COMPONENT
PARTIAL PAYMENT
Y /
N
INVOICE DATE
Y /
N
INVOICE #
AMOUNT
/
/
/
/
/
/
/
/
$ 0.00
CHARGE TO:
(may list one or multiple foapals)
FUND
ORG
ACCOUNT CODE
ACTIVITY CODE
AMOUNT
$ 0.00
TOTAL
Receipt of travel advances: I agree to submit an expense report upon completion of trip or
expenditures. If not settled within 60 days from date I received above advance or return from travel,
WPI may deduct the amount from my payroll check.
Financial Manager Approval
Date
Originator Signature OR
Date
Person receiving funds for travel advance
Financial Manager's Printed Name
Originator's Printed Name
Controller's Office Approval
Date
Please allow 7-10 days after submitting to Accounts Payable for processing.
Rev:7/1/12
Incomplete or inaccurate requests will delay processing
WPI CHECK REQUEST
(Send to Accounts Payable)
Payable to:
For Accounting Use Only
Banner ID #/Vendor #:
Seq #:
Due:
Remit to address:
Doc #:
Document Accounting "Off"
Title To:
FG
/
SR
/
LS
/
WPI
1099:
Y / N
SPECIAL HANDLING INSTRUCTIONS (Enter "X")
Indicate if Credit Memo:
(Must be on a separate request)
Mail with enclosure
Send to WPI Box
Send to Dept. _____________
Call ____________________ @ ext.________ for pickup
Purpose/Description
Accounting Use Only
Asset Type
Attach the following:
Original Invoice
Purchase Order (copy)
Packing Slip (copy)
WPI Vendor Justification Form
(for purchase $10,000 and over)
FABRICATION
COMPONENT
PARTIAL PAYMENT
Y /
N
INVOICE DATE
Y /
N
INVOICE #
AMOUNT
/
/
/
/
/
/
/
/
$ 0.00
CHARGE TO:
(may list one or multiple foapals)
FUND
ORG
ACCOUNT CODE
ACTIVITY CODE
AMOUNT
$ 0.00
TOTAL
Receipt of travel advances: I agree to submit an expense report upon completion of trip or
expenditures. If not settled within 60 days from date I received above advance or return from travel,
WPI may deduct the amount from my payroll check.
Financial Manager Approval
Date
Originator Signature OR
Date
Person receiving funds for travel advance
Financial Manager's Printed Name
Originator's Printed Name
Controller's Office Approval
Date
Please allow 7-10 days after submitting to Accounts Payable for processing.
Rev:7/1/12
Incomplete or inaccurate requests will delay processing