Accounts Payable Web Request Form

School/Department

Department

Please add your department info, if relevant.

Submitter Name *

Submitter Email *

Submitter Phone Number *

Format: xxx-xxx-xxxx

Is this transaction related to a sponsored project? *

Yes

If yes, please choose the POD or Dept. Personnel

POD or Dept. Personnel

Vendor Name *

If an individual, put last name first.

Invoice Number *

Invoice Amount *

Please enter values without commas.

Invoice Date *

What is the date on the invoice?

PO Number

Is this submission for student or non-employee travel/reimbursement? *

Yes

Is this an International Vendor? *

Yes

Priority *

Standard

High

Payment is time sensitive or business critical.

Comments Please add any additional comments (255 characters remaining)

Attachment 1*

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