Central Billing Request Form
Today’s Date
Requested by
Email Address
(please provide for electronic invoicing)
Contact Person Phone Number
Date of Service Amt to be billed
Description of Service/Workshop:
(this will appear on your invoice)
Deposit Revenue to:
Fund: Org: Acct:
Please use below if you have more than one F/O/A for deposit:
Amount Fund Org Acct Prog
Please forward to centralbilling@stockton.edu