1) Please make sure originals and copies, to go back to vendor, are attached

2) Please indicate if check is not to be mailed out to vendor [ex. "Held at Bursar's Window" or "Mailed to Department"]

3) Social Security or Federal Tax ID Number

4) Vendor & Department Contact Information

5) Sign

6) Date

7) Order Information including: invoice number & date, description of goods/services, account number to be charged, subtotals & total

8) Additional information or instructions concerning order and/or handling of check

ADDITIONAL INFORMATION:

• On the reverse side of the check request, you wil find instructions and information about when checks are avaliable.