EmailMe Form - AOP Departmental Expenditure Requisition Form

Program *
AOP
CUB
LSAMP
McNair
TS
UBMS
Select all that apply.
Name of Requestor *
First Last
Requestor's Email *
Name of Approver
First Last
Required if:
the requestor is not Program Director or Grant PI
a payment is being made to staff member
Expense Approver E-mail
Please select which form is needed *
Working Fund
Requisition (to Procurement via SSC)
Payment Request
Miscellaneous Payment (Staff Reimbursement)
PCard
Unsure
Name of Vendor/Payment made to: *
Address of Vendor

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Has the vendor been used before (Is the vendor already in PAW)? *
Yes
No
Unsure
N/A
Description of the Purchase *
Special Notes (Deadline, memo line notations, etc.)
Date Required
MM / DD / YYYY
Is this a recurring charge? *
Yes
No
Unsure
If the charge is recurring, how frequently?
Chartstring Allocation

% Amount Fund Dept PFin Account Project Activity ID

CS 1

CS 2

CS 3

CS 4

CS 5
Total
$ Dollars . Cents
Supporting Documents
Working Fund -
Requisition -
Payment Request -
Miscellaneous Payment -
PCard -
Supporting Documents 1
Supporting Documents 2
Supporting Documents 3
Supporting Documents 4