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Policies and Procedures FDS - FS - 026 Page 1 of 5 Accepted: 10/11/2006 Date Last Modified: 10/16/2006 PEID: Fiscal use Payee: V_ _ _ _ _ _ CHECK REQUEST FORM Address: Amount Project # Object Code _______________ _______________ _______________ _______________ _______________ $ - ___ ____ _ ___ ____ _ ___ ____ _ ___ ____ _ ___ ____ _ Total Requested ____ ____ ____ ____ ____ Business Purpose/ Benefit to University / Justification for expense: Date_____/_____/______ Date_____/_____/______ Date_____/_____/______ Description: Requested by__________________________________________ Ext # or email: Unit Approval___________________________________________ Unit Approval___________________________________________ 2nd approval required always if over $250 P/U check _______ Mail check _______ (30 characters maximum) - optional; will print on the check stub This section: Fiscal use only except "2nd Ref" Invoice # (16): Invoice Date: Relate Codes: _ _ Invoice Amount $ - Due Date:_____/_____/______ 2nd Ref enter here (16 characters maximum) - optional; prints on IFAS reports Separate Ck: _ _ Addr:: __ Misc: _ _ _ _ Funds Available:___________ Fiscal Approval:______________________________ D:\Docstoc\Working\pdf\d721c820-c656-478f-b8ab-71cf618cb6d9.xls PEID: V_ _ _ _ _ _ SAMPLE MULTIPLE CK CHECK REQUEST FORM- for Multiple Invoices for One Vendor Fiscal use Payee: Address: Amount Project # Object Code Description Invoice # _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ _____________ $ - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ 23 Business Purpose/ Benefit to University / Justification for expense: Date_____/_____/______ by___________ Requested Ext # or email: P/U check _______ Date_____/_____/______ Unit Approval__________________________________________ Date_____/_____/______ Unit Approval___________________________________________ 2nd approval required always if over $250 Mail check _______ Description enter here (30 characters maximum) - optional; will print on the check stub This section: Fiscal use only except "2nd Ref" Invoice # (16): Invoice Date: Relate Codes: _ _ Invoice Amount 0 $ - Due Date:_____/_____/______ 2nd Ref (16 characters maximum) - optional; prints on IFAS reports Misc: _ _ _ _ Funds Available:___________ Separate Ck: _ _ Fiscal Approval:______________________________ Addr:: __ OBJECT CODE 4100 4101 4102 4103 Staff Support: Auto allowance/lease Personal car mileage/parking Individual membership/professional meetings Club dues/Minimum spending not used Individual professional dues e.g., AICPA Professional breakfast/lunch/dinner meetings, e.g., rotary club monthly meeting Recruitment/relocation Payment for actual moving expenses (moving company, airline tickets) NOTE: moving expenses can only be paid to 3rd party vendor Travel for prospective employees Recruitment meals Employment Ads Training/professional improvement UH Foundation staff - training and travel Seminars, classes that improves the individual, e.g., computer classes Other Benefits Materials & Supplies: Books/subscriptions Internet subscription services Duplicating/printing/binding Combine film and film processing if submitted all together Postage/freight/delivery charges Cardinal Mailing Supplies - office Paper, envelopes, pens, etc. Office computer software (Word, Excel) Supplies - other Water and water rental - Menehune Water, The Water Man Coffee supplies - cups, napkins, plates, utensils Rental of gas cylinders - Gaspro & Liquid Air Other computer software (Academic software) License agreements for software system Film - if purchased separately from processing Frames - ready made Table centerpieces for receptions Equipment - expendable Equipment under $1,000 Equipment over $1,000 and less than $5,000 that is NOT theft sensitive Furniture & Fixtures - expendable Furniture & fixtures under $1,000 Furniture & fixtures over $1,000 and less than $5,000 that is NOT theft sensitive Administrative Expenses: Annuity Bad debt Institutional memberships E.g., - Accreditation Memberships 4104 4105 4106 4200 4201 4202 4203 4204 4205 4206 4207 4300 4301 4302 4303 4304 4305 4306 4307 4308 4309 4310 4311 4312 4313 Insurance Interest/service fees Rental - facilities Storage expense - File Connection Lease rents - land Room and equipment rentals Rental - other Equipment rentals Plant rentals Repairs/maintenance-equipment & software (upgrade of software) Repairs/maintenance-grounds & facilities Taxes Telephone rental/services Internet access lines Utilities Other administrative expenses Courier services Temporary help 4400 4401 4402 4403 4404 4405 4406 Professional Services: Audit Consultant services Fuel Communications, Marts & Lundy Travel for consultants e.g., Marts & Lundy Investment management Lecturers/Speakers Legal Services Other Services Engraving, matting & framing of awards Animal per diem If sole proprietor, need to separate services from printing charges Program Expenses: Advertising Business meetings Include parking expense w/ meal, if applicable Refreshments/meals for lectures/workshops/seminars w/ business purpose Entertainment/goodwill/development Golf Tournament fees Purchase of dinner/lunch tables for fundraising events Meals with donors Parties - e.g., appreciation parties Meals to show appreciation Include parking expense w/ meal, if applicable Leis & Floral arrangements for funerals Xmas cards Fundraising events/sales Items that donor will get that are listed on event worksheet i.e. golf fees paid for participant, meals provided to participants Gift premiums/recognition Membership package gift items. 4500 4501 4502 4503 4504 4505 4506 4507 4508 4509 4510 4511 4512 4513 4514 4515 4516 4517 i.e. golf umbrella, license plate frames, tents, - gift to member Grants/awards/prizes Non-student awards Receptions Can include printing of invitations, chair & radio rentals, decorations, etc. Registration fees Registration fees for seminars, conferences, etc. for staff to attend seminar Regrants to UH Alumni dual memberships Transfer salaries to UH Student scholarships/fellowships Room rental for Pavin Freedom Fellows - East West Center Travel Bus rental; van rental, car rental Taxi rental - for outside persons Telephone; parking Miscellaneous Athletic contest agreement Other Fundraising Expenses Cost of putting on the event Printing of invitations, postage to mail invitations, flowers for event, suplies UH Agreements Liquor Student awards/prizes Student grants 4600 4601 4603 4604 4606 4607 Capital Improvements: Construction/renovation Equipment All items in this category must have a gift and grant form and be logged Theft sensitive equipment over $1,000 - e.g., fax machines, microscopes, television sets, cameras, computers, printers, monitors, scanners, works of art, etc. All Equipment over $5,000 Furniture/fixtures All items in this category must have a gift and grant form and be logged Theft sensitive furniture/fixtures over $1,000 All Furniture/fixtures over $5,000 Depreciation Gain(loss) disposition of fixed assets

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