CHECK REQUEST FORM
The undersigned hereby requests a payment from the following fund of the Garnett Community Foundation (please submit a separate form for each payment requested). It is understood that this request is for payment of approved project-related expenses and is subject to review and approval by the Foundation’s Board Members to ensure compliance with fund guidelines, IRS regulations, and the charitable purposes of the Foundation.
Date of request:
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Month
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Day
Year
Date
Fund name:
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Amount Requested ($250 minimum):
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Payee Name/Organization:
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Purpose/Description of Expense:
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Payee Address:
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Street Address
Street Address Line 2
City
State
Zip Code
Payee Phone:
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Please enter a valid phone number.
Supporting Documentation (attach all):
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Original receipts, invoices, or other supporting documentation must be included with this form. Vendor invoices must include sufficient detail of goods or services provided; statements alone are not sufficient.
Cancel
of
Payment Requested By:
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First Name
Last Name
By signing this form, I certify that I am authorized to request payment from the Fund stated above and that the requested payment is for legitimate project-related expenses in accordance with the Fund’s guidelines and the charitable purposes of the Garnett Community Foundation.
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SUBMIT
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