HG: PAYMENT REQUEST

HIGHER GROUND LLC

15821 VENTURA BLVD #370 ENCINO CA 91436
PAYMENT REQUEST
Project Name
Approver
Your Name
Your Email
Department
Vendor Name
If you have already submitted a purchase order or payment request for this same vendor and have provided all the necessary info, you do not need to enter again. If we do not have this vendor on file and you do not provide the needed information, payment will be delayed.

Please ensure the W9 is a legible PDF. Blank W9 form can be found here: https://www.irs.gov/pub/irs-pdf/fw9.pdf

For payment details, please upload the Vendor Payment Acceptance Form (USD).
Is this a new vendor?
Vendor Email
Vendor Phone
Format: (000) 000-0000.
Upload Vendor W9 + Vendor Payment Acceptance Form (USD)

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Invoice #
If you have multiple invoices for the same vendor, you can submit under one payment request if they fall under the same PO or have no PO. Please list out each invoice number separated by commas.
Total Amount Due
Upload Invoice

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Do you have an approved PO for this request?
PO #
Does the invoice match the approved PO?
How much over?
What is this invoice for?
Account Code
Where this cost codes in the budget - if you do not know, you can leave blank.
Payments are processed within 48-72 hours. Click RUSH if this payment is needed sooner.
When do you need this request by?

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Hour MinutesAM/PM Option
Additional Comments?
Should be Empty:

PAYMENT REQUEST