Harlan Band Booster Organization Purchase/Payment/Check Request
Date of Request
*
-
Month
-
Day
Year
Date
Name of Requestor
*
First Name
Last Name
Requestor Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Request Type:
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Purchase (Amazon, Home Depot, Lowes, etc.)
Payment (Quote or invoice from a vendor)
Check (1099 individual, reimbursement, refund, etc.)
Game Day/Competition Meal Receipt Upload (HBBO funds only)
Purchase Request
Frequency of Purchase.
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One-time
Recurring
Vendor Name (ONE vendor per purchase request):
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List of Items Needing to be Purchased. (Provide description, item number, dimensions, quantity, price, etc. for each item.)
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Cart/Wish list URL:
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Upload Quote:
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Estimated Cost:
*
Justification for Purchase:
*
Payment Type:
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HBBO Funds
Raise Right Gift Card - HBBO Funds
Personal Funds (donation)
Personal Funds (to be reimbursed)
Product Delivery:
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Pick-up
Delivery
Requested Delivery Address:
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I understand that approval of this request does not authorize payment or authorize me to place the order. If approved the HBBO Outgoing Treasurer will communicate with the vendor to arrange payment and place the final order. If I place the order without prior authorization I may be responsible for full payment without reimbursement.
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I understand.
Payment Request
Is this a Registration/Band Fees-related Payment?
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Yes
No
Vendor Name: (ONE vendor per payment request)
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Description of Item(s) or service.
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Upload Invoice/Quote:
*
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Payment Amount:
*
Justification for Payment:
*
Product Delivery:
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Pick-up at Vendor location
Delivery
Digital/eDelivery
N/A (service, e.g. marching judge)
Requested Delivery Address:
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Harlan Band Booster Organization ATTN: Hugo Escobedo 14350 Culebra Road San Antonio, TX 78253
Check Request
Delivery method:
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USPS Mail (must have full address)
Send to Band Office
Requestor will pick up
Payee will pick up (must have phone number and email)
Payee Name:
*
First Name
Last Name
Payee Address:
*
Payee's Cell Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Payee's Email:
*
example@example.com
Amount:
*
Invoice/Receipt/Supporting documents upload:
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Drag and drop files here
Choose a file
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of
Justification for Payment:
*
Game Day/Competition Meals Receipt
Pre-approved expense
Vendor Name:
*
Receipt Amount:
*
Upload Receipt
*
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Drag and drop files here
Choose a file
Cancel
of
I have reviewed the above information. By checking the box below I certify that the information is true and accurate.
*
Yes
Submit
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