DLC Invoice Submission/Check Request

ONLINE CHECK REQUEST FORM
Check Request Submission Date
Check Request Number
Requester Information

Enter your information in the section below.
Name:

First NameLast Name
Email:
example@example.com
Expense Approver:
Vendor & Purchase Information:

Enter the vendor information below.
Vendor Name
Invoice Due Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Invoice Number:
Invoice/Expense Description:
Is the invoice split between multiple departments/accounts/funds?
Fund:
Department:
Expense Account:
Class:
Grant:
New Special Program/Activity:
Invoice Total

Upload Invoice Copy:

Browse Files
.pdf, .jpg, .png files accepted as uploads Cancelof
Should be Empty: