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Buckingham, Television, Inc. Check Request Form
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Vendor Name:Date
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9/16/2025
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Street Address:CKREQ#
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Suite/Apartment:
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City, State, Zip
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Project:
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* New Vendors must complete an IRS W-9 Form
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Disposition of Check (check or complete box)Buckingham Television, Inc.
6007 Sepulveda Blvd.
Van Nuys CA 91411
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Mail to above address:
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Hold in Finance:
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Give Check to:DO NOT USE ASAP
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Date Check Needed:
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(Please include tax for each line item)
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Date(s)DescriptionAccount CodeAmount
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Total:$0.00
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Requested Amount: $0.00
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Requested By (Print):
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Signature:
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Date:9/16/2025
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Notes/Description:
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LP/PM ApprEVP ApprFinance Appr
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