CARTER TEMPLE: CHECK REQUEST/PURCHASE REQUISITION
Please complete this form as completely as possible.
DATE:
/
Month
/
Day
Year
Date
NAME:
*
ADDRESS:
PHONE:
REQUEST FOR:
CHECK(S)
PURCHASE
REIMBURSEMENT
MAKE CHECK PAYABLE TO:
THIS REQUEST IS FOR THE FOLLOWING MINISTRY (LIST MINISTRY):
PURPOSE OR USE:
DATE NEEDED:
*
-
Month
-
Day
Year
Date
REMARKS:
ITEMIZE CHECKS BELOW (Be sure to separate, list on separate lines, etc.):
TOTAL AMOUNT:
*
Signed
Clear
Approved By (Office Use Only):
Received by (Office Use Only):
PLEASE SUBMIT AT LEAST (2) WEEKS IN ADVANCE.
Submit
Should be Empty: