MONMOUTH UNIVERSITY
West Long Branch, NJ 07764
PAYMENT FOR
CONTRACTED AND PROFESSIONAL SERVICES
(1) NAME OF PAYEE: __________________________________
STREET: __________________________________
CITY: __________________________________
STATE: _______________ ZIP: ___________
(2
) SOCIAL SECURITY #:
_________________________
OR
FEDERAL IDENTIFICATION #:
__________________
(3) PAYEE IS INCORPORATED NOT INCORPORATED.
(4
) REQUEST FOR PAYMENT
(a) IF INVOICE HAS BEEN RECEIVED, ATTACH IT TO THIS FORM, SIGN THIS FORM AND FORWARD BOTH
TO THE ACCOUNTS PAYABLE OFFICE, EXCEPT FOR PAYMENTS TO INDIVIDUALS, WHICH MUST BE
FORWARDED TO THE HUMAN RESOURCES OFFICE.
(b) IF NO INVOICE IS ATTACHED, COMPLETE THE INFORMATION BELOW, SIGN THIS FORM AND
FORWARD IT TO THE ACCOUNTS PAYABLE OFFICE, EXCEPT FOR PAYMENTS TO INDIVIDUALS, WHICH
MUST BE FORWARDED TO THE HUMAN RESOURCES OFFICE.
(5) Budget Manager: _______________________________ Total
Account Number: ____________________
Date: ____________________
U
pdated February 2015
FOR BUSINESS OFFICE USE ONLY - APPROVAL FOR PAYMENT
__________________Date ___________________________________ Human Resources Dept.
__________________Date
_______________ _________________ Accounts Payable Dept.
__________________Date ___________________________________ Controller’s Office
__________________Date ____________________________________ Finance & Budget Office
THIS FORM IS TO BE USED FOR ALL PAYMENTS MADE TO INDIVIDUALS WHO ARE NOT EMPLOYEES OR TO
ORGANIZATIONS FOR CONTRACTED OR PROFESSIONAL SERVICES. THIS INCLUDES, BUT IS NOT LIMITED TO,
PAYMENTS TO ATTORNEYS, LECTURERS, SPORTS OFFICIALS, MODELS, CONTRACTORS, ENTERTAINERS AND
CONSULTANTS
.
FAILURE TO USE THIS FORM FOR SUCH SERVICES MAY RESULT IN DELAY OF PAYMENT.
THIS MUST BE COMPLETED FOR EACH PAYMENT REQUEST.
For Business Office Use Only
Vendor#: __________________________
V
oucher#:__________________________
