Third Party Funds Request

Third Party Funds Request

***All requests must go through the Third Party Fund Approval Committee
Process:
1. Provide information related to item(s) being requested including photo, description, and pricing
2. Complete this request form.
3. Complete MSA order form and upload as requested below.
  - Include item number and other helpful indentifying information.
  - If item(s) are found on Amazon, include pricing from Amazon AND if possible, information and pricing from another company.
    
    Use of credit cards for payment is much harder for Financial Services department to track
4. Discuss requests with your supervisor for other possible fund sources. Complete this section on this request form.
5. If there are no other funding sources available, complete the section on the request form.
6. Submitted requests will be sent to supervisor for approval and then to Karlene Bleninger to schedule for review with the TPB Funds Committee.
7. Karlene will notify you of the results from the committee meeting.
Date:

MonthDayYear
Name of person making request:
Requester email:
example@example.com
Description of proposed purchase:
Upload completed MSA Purchase Order Form:

Cancelof
Upload photo, description, pricing information:

Cancelof
Cost:
Who would it benefit and how?
Are there other potential funding sources for this purchase ? (Please list):
Did you contact your supervisor?
Supervisor email:
example@example.com
Do not submit form until you have contacted your supervisor about this request.
STOP - The following is to be completed by the Third Party Billing staff only.
Third Party Billing Staff Comments:
Should be Empty:

Third Party Funds Request

Process: