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Finance Requisition
FBC-W FINANCE REQUISITION FORM
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Date:
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Account Category:
Subaccount Line Number:
Subaccount Name:
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Payment Amount Request:
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Make Check Payable To (name and full address):
Give Check To (if applicable):
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Payment Due Date:
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Submitted By:
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Purpose:
FINANCE COMMITTEE INFORMATION ONLY
Invoice/Receipt Provided:
Yes
No
Approved:
Yes
No
Date Approved:
If Applicable, Disapproval Reason:
Finance Committee Member:
Check #:
Invoice #:
Date Paid:
Receipt #:
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