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Accounts Payable Check Request
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This form is for direct pay transations such as non-wage business expense reimbursements; do not use for travel-related expenses; please use the appropriate travel form available on the Finance Office Portal. To ensure payment in a timely manner, please complete the entire form and obtain necessary signatures. Forms with incomplete and/or inaccurate information will be returned to the requestor for correction, and may result in delays.
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Payable to
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Street Address
Please Select:
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City
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State/ZIPNew vendor
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Must submit one of the following:
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W-9 (US Company or Individual)
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Requested By
W-8 BEN (Foreign Individual)
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Department
W-8-BEN-E (Foreign Company)
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Phone Extension
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Email
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Date Submitted
Existing Vendor
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Due Date*
Wilkes Student
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Wilkes Employee
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*Please allow 7-10 days for processing
WIN
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Please select a delivery method:
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Pick up at Miller Hall
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Deliver via interoffice mail
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Accounts Payable Use only
Send via USPS mail (no attachments)
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Service (1099)
Send via USPS mail with copies of attachment(s)
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Direct deposit
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Authorization form must be on file to request direct deposit
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Enter Fund-Org-Account-Program (FOAP) below
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Check requests with missing or invalid FOAPs will be returned to the originating department for correction.
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If you are uncertain of the FOAP, please email accounting@wilkes.edu prior to submitting a check request.
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Description of Expenditure (Required)FundOrgAccountProgramActivity Total
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Total Amount of Check Request: -
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Required for All Requests:
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I hereby certify that all expenses on this report were
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incurred on behalf of Wilkes University and to support the
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department (or grant) to which funds are charged.
Required for Grant Expenses ONLY: I certify that these charges are allowable under the terms of the grant/contract:
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Signature - Requestor
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Signature - Budget Manager or VPOSP Signature
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Print Name - Budget Manager or VPPrint Name
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Remit to:
accountspayable@wilkes.edu
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32 West South Street Wilkes-Barre, PA (MILLER HALL) THIRD FLOOR
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