Date Paid: ___/___/___ Check
Number: _____Bank_____
Email Notification to _____________________________
Requestor: ___________________ Phone Number: ________________Date:___/___/__
Fax Number: _____________ E-Mail Address: _________________________________
Payee (CANNOT BE one of the authorizing signatures below):__________________________
Payee Address (include street, city, state and zip):________________________________
________________________________________________________________________
Total Amount of Check requested: $___________ (Lab school is tax exempt; DO NOT
include sales tax)
Complete the following table, to correctly debit the expenditure. One invoice or receipt may be broken down between several categories/subcategories. Coding should follow how expenditure was budgeted.
Account Coding |
Amount |
Description for Ledger |
||||
|
Council/Program/Event |
Category |
Subcategory |
Dollars |
Cents |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TOTAL CHECK AMOUNT |
|
|
|||
This request must be approved
according to the following guidelines. If more than one signature is required,
use any of the lines provided. One person who has budgetary authority for the
council/program/event being charged is ALWAYS
REQUIRED!
|
Signature |
Printed name |
Date |
Authority Guidelines |
|
$0-500
included in approved budget |
|
|
At
least one person who has budgetary authority for council/program/event |
|
$501-2,500
included in approved budget |
|
|
Two
people who have budgetary authority for the council/program/event being
charged. If only one person has authority, then Pres, Pres-elect, Treas, or Treas-elect can be
the 2nd signature. |
|
$2,501-
and included in approved budget |
|
|
one
person who has budgetary authority for council/program/event being charged
and one of Pres, Pres-elect, Treas, or Treas-elect |
Instructions:
1. An original, completed check request form
and original receipts, invoice or grant request must accompany every
disbursement request. The requestor and signatories should keep a copy of the
form plus a copy of all back up.
2. Check requests with proper signature
authority and documentation must be received by the treasurer-elect within 30
days of date of expense.
3. Checks will be cut at least twice a month,
on the 1st and 15th of each month. Check requests received with proper
signature authority and documentation and within timing outlined above will be
processed.
4. Incomplete check requests, including check
requests with the proper signatures, will be returned to the requestor.