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Form
Name:
REQUEST
FOR CHECK (CHECK INVOICE)
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Used
for:
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Reimbursement
of out of pocket expenses for minor supply purchases (under
$500), postage, telephone, copying, business meals and
hospitality costs, and incidental charges.
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Payment
to vendors for utilities, dues and memberships, and subscriptions.
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Payments
for moving expenses, and short term professional service
agreements as defined in the policy for Independent
Contractors.
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Replenishing
departmental petty cash funds.
Required Fields:
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Pay to: |
Name
in which the check is to be made out. |
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Address: |
Mailing
address or campus box or instructions for pick-up in emergency
situations. |
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Dates: |
Today's
date and the date by which check is to be mailed or made
available. (allow 3-5 days for processing). |
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Originating Dept: |
Department
Name. |
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Ship
to:
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Used
for instructions to the vendor only. |
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Items
or Description:
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Detailed
explanation on the purpose for the payment. Show Tax ID
and home address here. |
| Amount(Column): |
Show
total amount of check request. Use $xxx.xx format. |
| Signatures: |
Authorized
departmental signatures for the account(s) being charged. |
| Accounting
code: |
Six-digit
FRS account number, four-digit subcode. |
| Account
Desc.: |
Name
of the account being charged. |
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Amount: |
Amount
distributed to the account number listed. Use xxx.xx format. |
Documents to Attach:
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All
orginal invoices or receipts justifying requested amount.
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Copies
of signed short-form (under $2,000) consulting agreements.
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Business
Meals & Hospitality form for all employee functions,
luncheons, gifts or donations.
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Any
letter or memo which serves as clarification or explanation
for the requested amount.
Where to Send:
After
proper departmental approvals are obtained, send two copies
of the Check Invoice with the original documentation to
Accounts Payable. This office will forward to ORA or Purchasing
for approval, as necessary.
How to Obtain:
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Form
is available in University Stores, form #60200. Use Stock
Issue Slip form to order.
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Many
departments have developed a computer facsimile of this
form, which is acceptable. Please check format with Accounts
Payable before implementing.
download available
Special Notes:
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While
this form has many purposes, there are two reoccurring
misuses of this form. (1) When ordering goods or materials
in excess of $500, a University Purchase order is required,
and (2) Payments for services provided by individuals
who are Brown
students or employees must be processed through Payroll
Office.
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Two
copies of the check invoice form are required because
one copy is returned with the check. Copies of supporting
documentation are not required by accounts payable.
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