Finance & reimbursement Check Request Form Leave this field emptyRequestSupporting documentation must be attached. Bring or send it with the printed form.Date *Requested by *Issue check toName *Address *City/State/Zip Code *SS# or FEID#Required by the Business Office for payment. Do not enter a Social Security number here if you would rather write it on the printed form.Payment detailReason *Account # *Vendor # *The vendor number must be completed.Amount ($) *Mailing instructionsMailing instructions *Send check to originatorMail check in attached envelopeOtherOther instructionsApproval — the Principal, date and Superintendent/CFO boxes are completed by the district after the request is received.Submit check request
