Fill - Free fillable Paymentrequestform 2014 Student Organization Payment Request Form PDF form

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StudentOrganizationPayment

RequestForm

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Pleasenote:

• Ifyouareinneedofsupplies,completetheorderformonthebackpage.

• StudentLifehasaccountswithOfficeDepot&Sam’sClubandcangetitems

foryou.PleaseallowoneweekforSam’sCluborOfficeDepotorders.

 MCCwillnot

reimbursetax.TaxexemptformsareavailableinStudentLife.

• Planyourbudgetinadvance.Checksandreimbursementscantake2‐3

weeks.

Pleasefollowthestepsbelow:

1. Allinformationmustbecompleted.

2. Originalanditemizedreceipts,orderforms,orcontractsmustaccompany

allrequests.Proofmust

beshownthatthemoneywas/willbespentonthe

appropriateprogramsoritems.

3. Ifyouarepayingforaservice,theorganization/individualyouarepaying

mustcompleteasignedW‐9taxform.AW‐9isavailableinStudentLife.

4. Youmustsubmitpaymentrequestforms3

weekspriorinordertoreceive

fundsontime.Productordersrequire4weeks.

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CompletedPaymentRequestFormsmustbeturnedintotheStudentLifeOffice

inA252.

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WHATISTHEREASONFORTHISREQUEST?

Pleasecheckone:

 Reimbursement(Originalitemizedreceiptmustbeattached)*Reimbursements

arenotguaranteed.

 Paymenttoacompanyforgoodsorservices(Companyinvoicemustbeattached)

 Honorariumforservice

 Donation(Proofofraisedanddepositedfundsmustbeprovided)

 Placeanorderonothersideofform(supplies,Sam’sClub,groceries,etc.)

 Other________________________________________________________________

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TaxexemptformsarealwaysavailableinStudentLifeforschoolpurchases.Only

original,non‐markedreceiptswithonlyschool‐relatedpurchases.

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PAYMENTISTOBEMADETOTHEFOLLOWING

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THISORDERISTOBEPLACEDAND/ORPAYMENTISTOBEMADETO:(Writeclearly)

 Paytotheorderof__________________________________________________

 Sam’scluborOfficeDepotPurchase

ISTHISAPREVIOUSLYPAIDINDIVIDUALORORGANIZATION?

YESNOIfno,vendormustcompleteaW‐9andattachtothisform.

COMPLETETHEFOLLOWINGINFORMATION

StreetAddress_________________________________________________________

City/State/Zip__________________________________________________________

 PhoneNumber_________________________________________________________

EmailAddress_________________________________________________________

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IfStudent,StudentIDNumber:____________________________________________

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COMPLETETHEFOLLOWINGFORALLREQUESTS

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Today’sDate____________DateNeeded___________DateofEvent______________

StudentOrg._________________________________________________________________

StudentContact:_____________________________________________________________

Phone:_______________________Email:______________________________

Specificeventoractivityforpaymentrequest:______________________________________

DidSenateapprovetopayforthisevent?_________________________________________

Ifyes,howmuchwasapprovedbySenate?________________________________________

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Advisor’ssignature___________________________________________________________

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**EVERYINDIVIDUAL/ORGANIZATIONBEINGPAIDMUSTHAVEARECENTW‐9ONFILE**

**REIMBURSEMENTSMUSTINCLUDEORIGINAL,ITEMIZEDRECEIPTS**

BLANKW‐9’sareavailablethroughtheOfficeofStudentLife&viaemail

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PLACINGANORDER

ExamplesincludeT‐Shirts,catalogs,onlinepurchases,OfficeDepot,Sam’sClub

requests

IFAPPROVALISNOTGIVENBYTHEOFFICEOFSTUDENTLIFE,THEREISNO

GUARANTEEPAYMENT(S)WILLBEMADE.

Itisnotnecessarytorewritetheorderonthisformifyouattachacompany

orderformorsalesquotationtothis.Acompanyorderformispreferred.

NOTE:ThisformmustbesubmittedtoStudentLifeapproximately4weeksprior

todateneeded.

ItemNo. ItemDescription Quantity CostperUnit TotalCost

 

  

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EstimatedShippingandHa ndling

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Total

$

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   DeliveryDate________________________________________

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