Request to Invoice a Customer

Please use this form to request an invoice to send to a customer, when the invoice does not fit any of our current billing processes, such as PASS.

Date: ____/____/____ Name of Requestor: ______Name of Department: ______When payment arrives, what department should the funds be deposited to? I.e. 136-323699-1/9200

______- ______- __ / ______

Who should we send the invoice to?

Company: ______Attn: ______Address: ______City ______State: ____ Zip: ______

Description of goods or service provided and information to be on invoice: (Example: 7/9/2015 1.5 hour staff time $97.50)

______

Please forward this form to: [email protected] General Ledger Office, Second Floor Brigham Hall, Attn: Carissa Menke