Ar/bi Invoice Request Form
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1AR/BI Invoice Request Form
Date:
_________________________ (mm/dd/yyyy)
: ______________
Requested by:
_________________________ Phone Number
Dept. Name:
_________________________
Customer Information
Name:
_________________________________________________________________
Address Line 1:
_________________________________________________________________
Address Line 2:
_________________________________________________________________
City: _________________ State: ____ Zip Code: _______ Phone: _____________ Fax: _____________
Billing Information
Description:___________________________________________________________________________
_____________________________________________________________________________________
__________________________________________________________________________________
(PLEASE include matching back-up documentation with invoice request)
Quantity:
_______________
Unit Price:
_______________
Total Bill Amount:
_______________
Accounting Information
The PeopleSoft chartfield(s) below will be credited the assigned amounts upon the completion of the invoice:
Account
Fund
DeptID
Program
Class
Project
AMOUNT
Please submit all requests to: Aaron Ledesma – SA 1121
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Parent category: Business