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NBC#4 Requisition Voucher
Note: Supporting Documentation (i.e., receipts) must be submitted to the Financial Secretary to offset funds spent.
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Today's Date
*
MM
/
DD
/
YYYY
Amount Requested
*
Your answer
Funds Requested By (Name of Ministry)
*
Your answer
Ministry Leader (Requestor)
*
Your answer
Name of Vendor Receiving Funds:
*
Your answer
Reason For Payment:
*
Your answer
Invoice No. (if applicable):
Your answer
Account No. (if applicable):
Your answer
NOTE: The remaining sections below will be completed by the Finance Office.
-Type of Disbursement
Cash
Check
Credit Card
Electronic Payment
Check #
Your answer
Bank Account
Operating Account - Old Second
Building Fund - Old Second
Operating Account - BMO
Approved By:
Your answer
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