PAYMENT AUTHORIZATION FORM
____________________________ PTA
Date _______________________________
Name of Person Requesting Check ______________________________________________
Phone(______) ______________________
PTA Position __________________________________________________________________
City/Zip ____________________________
Event or Assignment ___________________________________________________________________________________________________
Date of Event ____________________________________________
Amount Requested $_________________________________
Date Approved in Minutes _________________________________
❒
❒
Invoice attached
Receipt attached
Write Check To:
Name of Person/Company _____________________________________________________________________________________________
Address ______________________________________________________________________________________________________________
____________________________________________________________________________________ (_________) ______________________
City
Zip
Phone
Approved by:
_________________________________________________________
____________________________________________________
President’s Signature
Secretary’s or Financial Secretary’s Signature
For PTA treasurer use:
❒
❒
Membership-approved activity
Funds released by membership
❒
Executive Board-approved expenditure
Budget Category
Budgeted Amount
Check Number
Amount
417
California State PTA Toolkit - 2004