ISU - Interdepartmental Invoice Date Prepared
1-
Department Name Contact Phone #
2-
1
2
3
4
5
6
7
8
9
10
3-
1
2
3
4
5
6
7
8
9
10
Total Credits
(must equal Total Debits)
4-
Name Phone # Date
Debit
Account
(Expense)
Description/Invoice #
Amount
Department Supplying Goods/Services Contact Information
Funds to be debited
Accounting Debit Information
Department Receiving
Goods/Services
Date of
Service
Index
Funds to be credited
Total Debits (must equal Total Credits)
Department Receiving Revenue
Index
Credit Account
(Revenue)
Activity Code
Accounting Cr
edit Information
Hash Total
Complete form and submit with supporting documentation to Accounts Payable
-Stop 8219 or Fax 282-4725. Retain Copy for your Records.
Signature of Departme
nt Authorizing Expenditure
8991
8991
8991
8991
8991
8991
8991
8991
8991
8991
Activity Code
UBO Signature:
Amount
Rev Nov 2013
$0.00
$0.00
0.00