Paypal Approval Form

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University of Louisiana at Lafayette
Administration and Finance
Purchasing Office
104 University Circle
PAYPAL APPROVAL FORM
Form PUR-105
PAYPAL/THIRD PARTY PROCESSOR TRANSACTION DOCUMENTATION & APPROVAL
Request Date
Department
Contact
Phone
Fax
E-mail
Purchaser Information
Name
Address
City
State
Zip
Vendor Information
Vendor Name
Address
City
State
Zip
Description
Quantity
Unit
Unit Price
Total Price
Total *
* A copy of the PayPal Transaction Detail must be attached.
I certify that the item(s) listed above is a legitimate University purchase.
Approval
Signature
Title
Date
Employee
Supervisor
Purchasing
Form PUR-105
v1 (11/24/2015)

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