MPI Minnesota Chapter Check Request Form

Submit this form and upload applicable receipts, invoices and/or contracts.

Checks are cut/signed once a month. The deadline is the Friday before the board and member meeting.

After you submit this form, you will receive an email confirmation and it will be emailed to Strategic Alliances for approval to Staff.

Check Request Number

Fiscal Year *

2022-2023

2023-2024

*MPI's fiscal year is July 1 - June 30.

Today's Date

MM / DD / YYYY

Requestor Name: *

First Last

Requestor Email Address *

Payee Information

Payee Name

First Last

Or
Company Name

Payee Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Check Amount *

$ Dollars . Cents

When do you need this check cut by?

MM / DD / YYYY

Checks are cut/signed once a month. Deadline is the Friday before the board and member meeting.

Additional Instructions:

If no information is provided above, the check will be mailed via US Mail, to the payee.

Upload W-9

A check will NOT be issued until this has been provided/is on file for the current calendar year.

To make year-end financials as easy as possible, please make sure MPI has a copy of this payee's W-9. If you're not sure, upload it anyway.

FFI: Form W-9 is used by persons/organizations required to file information returns with the IRS to get the payee's correct name and TIN. For individuals, the TIN is generally a social security number (SSN).

Accounting Information

What is this check for? *

Please specify the event or program name and date so we can ensure accounting codes are correct.

If the check requested has more than two sets of codes associated (see below), indicate those additional amounts and the corresponding codes in the text box above.

Committee Code *

After you select a committee code, the corresponding set of expense codes will pop up. These codes are based on what is in the Board-approved budget.

Expense Code (for 100)

Expense Code (for 200)

Expense Code (for 240)

Expense Code (for 300)

Expense Code (for 410)

Expense Code (for 440)

Expense Code (for 900)

Upload Invoice(s) or Receipt(s)

You can upload multiple attachments.

After you submit this form, you will receive an email confirmation and it will be emailed to Strategic Alliances for approval to Staff.