Fillable As02 L O U I S I A N A S T A T E U N I V E R S I T Y

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As02 L O U I S I A N A S T A T E U N I V E R S I T Y

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U.S.A. forms for Louisiana State University

BROWSE LOUISIANA STATE UNIVERSITY FORMS

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Rev 6/16
Louisiana State University
Office of Accounting Services
Accounts Payable & Travel
217 Thomas Boyd Hall
MISCELLANEOUS CHECK REQUEST AS02
This form should be used to request payments for refunds or payments charged to revenue or liability accounts.
Third Party Documentation MUST be attached.
Request Date __________________________
Department
Contact
Phone Fax E-mail
Purpose of Payment ____________________________________________________________________________
***Fiscal Year End Accrual
Yes No
Supplier ID #
Document #
Doc Type MC
Payee
Address
City State Zip
U.S. Citizen
Yes No If no, citizen of ______________
Green card holder/
resident alien
Yes No If yes, a copy of the card must be attached.
Document Date
LSU Employee
Yes No
Separate Check
Yes No
Due Date
Remit Message
(limited to 60 characters)
Sales Tax
Freight
Additional Cost
Document Total
Spend Category
Program
Project
Gift
Grant
Cost Center
Fund
Function
Additional Worktags
Amount
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As02 L O U I S I A N A S T A T E U N I V E R S I T Y

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Completed 21 January 2020

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