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wesptatreasurer@gmail.com
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2400 Wakefield Pines Drive
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Raleigh, North Carolina 27614
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CHECK REQUEST FORM
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Event or Program:
_________________________________________________________________
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Date: ________________________________________________________________
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Name of Person Requesting Check: ________________________________________
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Email: _________________________________
 Phone #:
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Amount requested before tax:
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Sales tax amount:
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TOTAL AMOUNT REQUESTED:
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Purpose of Expenditure: ______________________________________________
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To whom should the check be made out to:
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Name:
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Address:
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* If this is a new vendor please attach a W-9.
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* Please attach all receipts.
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Authorized by:
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___________________________
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Vice President/Committee Chair
SignatureDate
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TreasurerSignatureDate
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Treasurer's Use
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Date Paid:
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Check #:
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Budget Category:
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Initials:
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Notes:
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