New Mexico State University
Document #
Accounts Payable
AP
Are you using sponsored awards or
gifts on this form?
Phone 646-1189
Direct Pay
Yes - Route spa@nmsu.edu
Fax 646-1077
No - Route afr_approval@nmsu.edu
Instructions: Use this form for all payments in which no purchase order was issued. 1) Compile all information on request. 2) Include the
signature of a PI, Dean, Vice President, Community College President or their designee on original request. 3) Retain one copy of Invoice
and request for departmental files. 4) Scan and send form form to AFR at afr_approval@nmsu.edu or SPA at spa@nmsu.edu.
SECTION 1: REQUESTOR INFORMATION
Date (mm/dd/yyy):
Department:
Campus Box:
Requestor:
E-mail Address:
Phone:
SECTION 2: REQUEST DETAILS
Aggie ID:
Payee:
Remit To:
Name
Address
City, State, Zip
Description of Goods or Services
Amount
1.
2.
3.
4.
5.
Total from Continuation Page
Total
I certify that charges herein are correct and just and that payment therefore has not been received.
Payee Signature:
Index
Fund
Account
Travel Encumbrance or Subcontract Number
Amount
P/F
SECTION 3: OFFICIAL APPROVAL
Printed Name:
Signature:
Date:
Principal Investigator
Dean/VP/CC President
Designee
SECTION 4: CENTRAL APPROVAL
Fiscal Monitor Printed Name:
Signature:
Date:
SECTION 5: INTERNAL DEPARTMENT USE ONLY
Processed by:
Date:
Reset
Reset
AP-Direct-Pay.pdf, 04/2017
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