Invoice Payment Authorization Form
To be used
ONLY
when attached to a numbered invoice.
Do
NOT
attach more than one invoice to this form. If the invoice does
NOT
have a number use the Payment/Reimbursement Form.
PS Account
(6)
Fund
(3)
Dept ID
(7)
Project/Grant
(6)
Amount
(insert a decimal)
Description: (max. 30 characters) Appears on financial reports, not on check stub
PS Account
(6)
Fund
(3)
Dept ID
(7)
Project/Grant
(6)
Amount
(insert a decimal)
Description: (max. 30 characters) Appears on financial reports, not on check stub
PS Account
(6)
Fund
(3)
Dept ID
(7)
Project/Grant
(6)
Amount
(insert a decimal)
Description: (max. 30 characters) Appears on financial reports, not on check stub
PS Account
(6)
Fund
(3)
Dept ID
(7)
Project/Grant
(6)
Amount
(insert a decimal)
Description:
(max. 30 characters) Appears on financial reports, not on check stub
Grand Total
Prepared By:
Signature:_________________________________Phone:__________Date:
________
Authorized By:
Signature: ________________________________Phone:___________Date: ________