CAREB Check Request Form
Request for Single Vendor Check or Payment
Requested by
*
Requester MUST be a current Board Member
Board Title
*
Your email
*
example@example.com
Date of Request
*
-
Month
-
Day
Year
Date
Total Amount of Check Request
*
Event or Reason for Request
*
Preferred Payment Method:
*
Check Request
PayPal
Zelle
ACH (Automated Clearing House) Transfers
Payable to:
*
The vendor's business or personal name as registered with the bank, PayPal, Zelle, or who check should be payable to.
PayPal Email Address
Zelle Account (Phone Number or Email address)
ACH Payment Information
Rows
Payee's Bank Information
Bank Name:
Routing Number:
Account Number:
Account Type:
Email for Confirmation:
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Voucher/Invoice #
Voucher Request for Check and/or Payment
*
Rows
Description of Item to be Paid
Comments/Additional Info
Amount
1
2
3
4
5
Upload receipts and/or invoices
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Requestor's Signature
*
Print
Save
Submit
Should be Empty: