Manual Check Request - Check Requisition Form Template

YOUR LOGO HERE MANUAL CHECK REQUISITION DATE: ____May 19, 2008_____ To: ACCOUNTING DEPARTMENT Please issue a MANUALCheque to: (Name & Address) Details of payment: _________________________________________________________________________ Code: Code: $ $ TAXES: GST: ____ PST: ____ GST Amount: $________________ Rebate: ____ Special Instructions: Credit: ____ Requisitioned by: ________________________________ ______________________________ Bursar Authorization: Approved by: $ ____________________________ Form