DIRECTIONS FOR COMPLETING THE

DIRECT PAY REQUEST FORM

1.     No:                                   Your number, if you know your number.  If not, leave blank.

2.     Date:                                Today’s date.

3.     Amt:                                 Total of invoices attached.

4.         Vendor Number:              Search on WISDM under Vendor Name for their number.

5.          Pay To:                            Check payable to whom?

6.          Address:                           Complete address based on Pay To from the attached billing/Invoice.

7.          City, State, Zip Code:     Self-explanatory

8.          Department Number –    NEW i.e.:  102 301500 1

9.         Department Name:          Name of your department or budget name.

10.      Acct:                                 Is NEW – 4 digit – check under TABLES, Account Conversion Table to  find.

11.      Description                      Describe  what your paying for.

12.      IF this is a personal reimbursement to an individual, include signature of the Payee.

13.      Authorized Signature:       Whoever is authorized to sign for the department budget.