Request Form

Payment Request Form

Time since SPR Creation: 2 Days
-- Potential Duplicate --
-- Discrepant --

Payment Request Information

Request ID:
Request Creator:
Creation Date:

Invoice Information

Invoice Number:(required) Total Amount: $(required)

Invoice Date:(required) Received Date:(required) POP Date:

Retainage: Use Retainage

PO / Vendor Information

PO Search:
PO Number: Release:

(required)

Additional Handling

Delivery Method: FedEx
Send to 3rd Party
Hold for Pickup
None

Other Handling: Foreign Currency
Separate Check
Include Remittance
Other

FedEx Information

Note: Payment requests with FedEx delivery require an additional four business days after request is approved and payment terms are met.

Recipient Name
and Address:(required) FedEx Project Number:(required)

Signature Requested upon Delivery Saturday Delivery

Send to 3rd Party Information

3rd Party Name
and Address: (required) Phone:(required)

Special
Delivery
Instructions:

Hold for Pickup

Designee for check pickup.

Name:(required) [Select] [Clear] User ID: Phone:

Foreign Currency

Enter three character currency code (e.g., GBP)

Currency Code: (required)

Other

Description:(required)

Payment Request Line Items

Line Items (* = REQUIRED)

Attachments

Attachment Table

Action

Document

Date

Author

Delete

Invoice Scan.doc

04/23/2007

ROBINSONJ

Delete

Additional Scan.png

05/01/2007

ROCKR

Delete

Financial Calculations.xls

07/07/2007

PINKP

Comments [0 Comments] Comments:

Routing Options Technical Approver: (required) [Select]

Route:(required) For Approval For Review