.............VALENCIA COLLEGE
CHECK REQUEST
Date Completed: __________________ Date Requested By: ______________ (Do not use ASAP)
Form Prepared By: ______________________________________ Phone Ext: _________ Mail Code: ________
(Print Name)
Send Check To: _________________________________ Phone Ext: __________
Mail Code:___________ or Address listed below
Name/Payee: _______________________________________________ VID#: _____________________________________
Address: ___________________________________________________________________________________________________
City: ___________________________________ State: _____________ Zip Code: _______________
Quantity Description Unit Cost Extended Cost
___________________________________ ________________
Requestor Signature Date Grand Total ___________________________
__________________________________________________
Requested by (Print Name)
Charge to :
Index______________ Acct ____________
Amount $____________________________
________________________________________
Budget Manager Signature
_________________________________________
Budget Manager(Print Name)
Charge to :
Index______________ Acct _____________
Amount $____________________________
________________________________________
Budget Manager Signature
_________________________________________
Budget Manager(Print Name)
Charge to :
Index______________ Acct _____________
Amount $____________________________
________________________________________
Budget Manager Signature
_________________________________________
Budget Manager(Print Name)
All check request forms, other than EDF, should be sent directly to Accounts Payable at mail code DO-330.
EDF check requests should be sent to your ODHR Regional SOlution Center and then forwarded to
Accounts Payable at mail code DO-330.
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CHECK REQUEST FORM CHECKLIST
Print name of person preparing a check, include their phone extension and mail code.
Please complete Send Check To portion only if we are sending the check to a person other than the
vendor or payee. (e.g. for hand delivery)
Include Payee’s full name and VID#. Payee must be set up in Banner by Procurement.
Must include Payee’s current mailing address.
Complete description regarding payment. (As much info as possible)
If payment is regarding a trip, please include traveler’s name and travel date.
If payment is regarding an event, please include the date and details of the event.
Include and verify total amount to be paid.
Attach supporting documents regarding this payment being requested.
Include Index and Account numbers.
Print name of Requestor and obtain their signature.
Obtain Budget Manager’s signature.
EDF reimbursements should be sent to your ODHR Regional Solution Center for
approval. Send completed forms to Accounts Payable at mail code DO-330.
GUIDELINES
Check Request Forms should be only used when a vendor will not accept a purchase order or P-card.
Examples include:
Employee reimbursements and cash advance requests
EDF reimbursements and payments
Membership Dues
Hospitality fund reimbursements
Student reimbursements
Hotel payments
All other requests should be made using a Banner requisition or P-Card. Check Request requires a
signature from the budget manager and the budget manager cannot be the same person as the requestor,
nor can the requestor sign for the manager.
All Check Requests must include the Banner VID# and the correct name as set up by Procurement in the
database.
Check Requests cannot be used for contractors. Contractors must have a contract agreement and a
Purchase Order.