PURCHASE AUTHORIZATION AND CHECK REQUEST FORM
Date of Request
/
Month
/
Day
Year
Date
Person Requesting Check
Date Check Is Needed
/
Month
/
Day
Year
Date
Description of Item:
Item Description
Amount
Account #:
1
2
3
4
5
6
7
8
9
10
Total
Make Check Payable to
Address
Check Distribution Method:
Distribute Through Church Office
Mail To Address Below
Address to mail check to:
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Submit
Should be Empty: