Rev 06/16
Louisiana State University
Office of Accounting Services
Accounts Payable & Travel
217 Thomas Boyd Hall
NONRESIDENT ALIEN CHECK REQUEST AS441
Request Date _____________________
Department
Contact
Phone Fax E-mail
Purpose of Payment ________________________________________________
_________________________________________________________________
Payment via Mail check to Payee’s address (listed above)
Wire Transfer to Payee’s Bank Account * * MUST attach AS493, “Wire Transfer Request
Supplier #
Document #
Document Amt
PO #
Payee
Address
City State Zip
Spend Category
Program
Project
Gift
Grant
Cost Center
Fund
Function
Additional Worktags
Amount