Trinity Presbyterian Church - Authorization for Payment

PAYMENT REQUEST FORM

Please complete all of the information in the form below. When the form is submitted, it will be sent to the appropriate committee chair for approval. After approval, it will be sent to our Financial Administrator. If the payment can be made via ACH bank transfer or a check can be mailed, our Financial Admin will send the payment. If a physical check is necessary, our Financial Admin will work with the Treasurer to write a physical check, which will be available in the office.
ACH PaymentPhysical CheckNo Preference (ACH or Check)Is Set up to AutoPay (No Payment Necessary)Consider this a donation to TrinityCredit Card Receipt
Who is being paid? (Company or Individual Name)*
Email for the person or company being paid. *
example@example.com
Date Payment is Due

MonthDayYear
Date
NOTE: If this is a donation of goods and/or materials, the Committee Chair's approval is still required, AND the appropriate Committee and Account should be selected below. By submitting this form, the donor confirms that (1) they no longer own any portion of the gift, (2) no conditions were attached to this gift, and (3) no one else has rights to the property donated.
Mailing Address for the person or company being paid.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Amount for Payment*
Memo or Notes for the Payment.*
Please Select the Appropriate Committee Area*
Children & Family Ministry- 52011 Children's Sunday School- 52013 Vacation Bible Camp- 52017 Children's & Family Ministry - Other- 57500 Nursery SuppliesJr. & Sr. High Ministry- 52021 Jr. & Sr. High Curriculum- 52022 ConfirmationAdult Ministry- 52041 Adult Curriculum- 52042 DISCIPLE Program- 52045 Adult CE - OtherYouth Team- 57010 Retreats- 57013 Trinity Tribe- 57015 Service / Mission- 57016 Scholarship- 57017 Special Program / Seminar- 57018 General Program Support
Creation Care - ERC Projects8200 Special Offerings- 8201 One Great Hour of Sharing- 8202 Christmas Joy Offering- 8203 Thanksgiving- 8204 Christmas Eve- 8205 Pentecost Witness- 8207 Peacemaking- 8208 Other Offerings (Specify in Notes)8300 Service and Mission Payable- 8301 Lunch for the Soul Payable- 8307 LINK Payable- 8309 HES Payable- 8310 Hurricane Relief Payable56011 Committee Expenses56014 Minister's Discretionary Fund56015 Local Benevolences- 56015.1 Riverside Presbyterian Support- 56015.2 V.O.I.C.E.- 56015.3 Lunch for the Soul- 56015.6 Herndon Elementary School- 56015.7 Cornerstones- 56015.8 LINK56041 PCUSA Benevolences- 56041.1 Presbyterian Disaster Assistance56061 Mission Partners- 56061.1 National- 56061.2 International56071 Internal Giving- 56071.1 Youth Mission Trip- 56071.2 Trinity Tribe
55011 Singing Choir Supplies- 55011.1 Singing Choir Festival55016 Special Event Musicians55022 Music Copyright License55020 Handbell Choir Supplies55012 Handbell Repair / Maintenance55021 Handbell Festival55013 Organ Repair / Maintenance55014 Piano Repair / Maintenance55015 Communion Supplies55017 Worship Flowers55019 Worship Committee Expenses55024 Mic / Sound System Maintenance55026 Guest Preacher
51012 Pastor Annuity51016 Pastor Book / Study Allowance51017 Pastor Dental and Optional Life51019 Pastor RSP51022 Assoc. Pastor Annuity51024 Assoc. Pastor Auto Allowance51026 Assoc. Pastor Book / Study Allowance51091 Visiting Member51092 Substitute Organist51161 Child Care / Nursery5111 Continuing Education & Books - Other51062 Childcare Equip/Training51251 Miscellaneous Expense51213 Staff Mileage51204 Staff Training52152 Payroll Processing Fees
53021 Office Supplies53022 Postage- 53022.1 Postage Meter Lease53023 Equipment Maintenance / Repair53024 Equipment Purchases53025 Computer Software & Support53027 Copier Lease53028 Copier Usage53036 Fire/Liability/Worker's Comp Insurance53051 Stewardship Campaign53031 Custodial Supplies53032 Telephone & Internet53033 Electric53034 Gas53035 Water53041 Per Capita Assessment
59011 Snow Removal59012 Lawn Care59013 Equipment Repair59014 Equipment Replacement59015 Trash Removal59016 Painting59017 Heating & A/C Service59018 Other Property Maintenance59019 Electrical Supplies59020 New Equipment59021 Fire Alarm Service59022 Pest Control59023 Plumbing59124 Elevator Maintenance59151 Outside Custodial
60012 Social / Fellowship Supplies60013 Function or event cost60014 Administration60022 Membership60024 Community Nurture / Communications- 60024.1 Web Site60025 Congregational Care60026 ChristCare60029 Stephen Ministry
58011 Office Training / Retreats58012 Publications58013 Other Session Expenses58014 Member Counseling
21033 Handbells Payable21036 Youth Ministry Payable21042 Women's Retreat Payable21048 Workcamp Payable21053 Haiti Mission Trip2130 VBC Offering2340 Building Improvement Fund
Please Type in the Appropriate Memorial Fund*
Example: 23575 Undesignated Memorial Funds
Invoice, Bill, or Other Documentation for Expense.*

You are required to submit some form of documentation with the payment request, even if it is a screen shot of an email or message requesting payment.
Cancelof
Person Requesting This Payment*
Email for the Person Requesting this Payment*
example@example.com
Should be Empty:

PAYMENT REQUEST FORM