Instructions for Completing the Check Request Form
Please note that this Check Request Form is only to be used to request payment for items
that do not have an invoice. Invoices should be submitted for payment through the regular
accounts payable process. Supporting documentation is required to be submitted along with
the Check Request Form.
Request Information section:
1) Print or type in the name of the person submitting the request in the Request Submitted
2) Print or type the date of the request in the Request Date field.
3) Print or type the phone number in the Telephone Number field of the person submitting
the request .
4) Print or type the name of the person who has approved the request in the Approved By
5) Have the person in step #4 sign and date the form in the Approval Signature and Date
Vendor Information section:
6) Print or type the Vendor Number (if it is an existing vendor) or the VMW Request
Number (if it is a newly requested vendor) of the person/company being paid by the
check request form.
Note: A vendor must be set up in the vendor master file in order to receive a payment.
The VMW (Vendor Manager Website) can be used to look up an existing vendor
number or to request that a new vendor be added. When a new vendor is added they
are assigned a temporary VMW Request Number until a permanent Vendor Number
can be assigned.
7) If the vendor is to be paid differently than their regular terms, print or type the date the
payment is due in the Payment Due Date field .
Note: Vendors are set up in the vendor master file with the payment terms that the
vendor requires (e.g., net 10 days, net 30 days, etc.). These are the terms that will be
used to pay the vendor unless you instruct A/P to override those payment terms and to
pay by the date you enter into the Payment Due Date field instead.
8) Print or type the name of whomever the check should be made payable to in the
Vendor Name field.
9) Print or type the address of the person/company shown in step #8 in the Vendor
10) If you want this payment to be made by check, even if this vendor normally receives
their payment via ACH, answer the ACH question by unchecking the Yes box and
checking the No box .
Note: Some vendors prefer to receive their payments via ACH (electronically). These
vendors do not receive a physical check but they do receive the same payment details
normally shown on the check stub.
General Ledger Coding section:
11) Print or type the business unit portion of the general ledger account number that is to
be used to post this check request to the general ledger in the Business Unit field.
Object Subsidiary Acct. #
Business Unit Acct. # (if applicable)
4000 98 62 1234 . 68160 . 006
Job Costing # (omit if not applicable)
Service Line (P&L accounts only)
Service Type (P&L accounts only)
12) Print or type the object account portion of the general ledger account number that is to
be used to post this check request to the general ledger in the Object Account field.
13) Print or type the subsidiary account portion (if applicable) of the general ledger account
number that is to be used to post this check request to the general ledger in the
14) Print or type the corresponding amount in the Amount field for each of the general
ledger account numbers listed.
15) If a single general ledger coding line should have sales tax added to it, click the Yes
checkbox for that line.
Note: In step #18, you will have an opportunity to denote if all the lines should have
sales tax added to them instead of just certain lines.
16) Include any comment that you would like show on the general ledger in the Remark
field for each line. (Maximum of 30 characters.)
17) Print or type the total of all the amounts in the Total field of the Amount column.
18) If sales tax has not been charged and use tax needs to be added, uncheck the No
checkbox on the Total line and check the Yes checkbox.
Note: If only part of the check request needs to have use tax added, leave the No
checkbox on the Total line checked and check the appropriate Yes or No checkboxes
on each line of the General Ledger Coding section.
19) If the check is to be sent to the payee by some means other than regular mail, uncheck
the Mail to Vendor checkbox and check the Forward per Special Instructions below
checkbox. Detail those special instructions in the Special Instructions field.
Check Request Form
1) Supporting documentation - Any supporting documentation provided by the vendor or
generated by the requester (e.g., spreadsheets) should be sent to accounts payable
along with the form.
ded by the vendor or
o accounts payable
Check Request Form
Purpose: The purpose of this form is to request a payment for an item that does not have an invoice (e.g., charitable
contributions, sponsorships, memberships, general liability claims, Risk department claims, payments to customers, license
fees, tag renewals, job fairs, etc.). A separate form must be submitted for each item. Supporting documentation must
accompany this form.
Request Submitted By Request Date Telephone Number
Rena Watson 4/27/2007
Approved By (please print)
Approval Signature Date
The vendor must be set-up in the vendor master in order to create a payment. If this is an existing vendor, please enter their
vendor number below. If this is a new vendor, a request must be entered on the Vendor Manager Website (VMW) at
Vendor Number or VMW Request Number Payment Due Date
149777 upon receipt
Arkansas State Plant Board
If this vendor is normally paid via ACH, should this request also be paid via ACH? Yes No
General Ledger Coding
Object Should tax be added Comment to show on the general ledger
Business Unit Account Subsidiary Amount to this item? (30 character max.)
$ 60.00 Yes No
Total $ 60.00 Yes No (This Yes/No pertains to all of the items)
Mail to Vendor Forward per Special Instructions below
overnight to Branch
All Brands (except Terminix): Send the original form and supporting documentation to the ServiceMaster Accounts Payable
Department at 860 Ridge Lake Boulevard, Mail Stop C2-1594, Memphis, TN 38120.
Terminix Only: Fax completed forms and supporting documentation to (901) 597-7196.
Questions should be directed to the Accounts Payable Answer Line by emailing firstname.lastname@example.org or by calling
FOR ACCOUNTS PAYABLE PROCESSING
Date and Time Received
Batch Number Document Number Date Processed
bfd2972b-8461-4215-be89-03a6963ff8ad.xls.xls 5/16/2012 11:54 AM