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					                                                                                   Refund of Receipts/Sales Credit Form
Vendor #                                                                                           Cash Management, 21 N. Park Street, Suite 6101                                          Voucher #
                       0000568686
                                                                                                                                                                                           Additional Information/Justification:
Check Payable To: (Customer or Other)                                                                                                 County Tax          Tax
                                                                      Amount(s)            Account    Fund        Dept       Prog.                                              Project
(last name, first name, initial)                                                                                                      Code Name          Code                              Provide description of why money is being refunded

                                                                                                                               R
Send Check to (requires a mailing address):                                                 9224
Address 1:                                                                                  9220


Address 2:                                                                                                                     R
                                                                                            9224
City:                                                                                       9220


State:    Zip/Postal Code:       Country:                                                                                      R
                                                                                            9224
Refund Reference:                Payment Handling Code:                                     9220


                                                                                        TOTAL AMOUNT
Contact Information:               Date:
Name:                                                            E-mail:                                                             Telephone Number:
                              Please see the following website for Refund of Receipts/Sales Credit Form Instructions and Guidelines:
                                                            http://www.bussvc.wisc.edu/acct/instructions/refundin.html
I certify that I have reviewed this refund payment and find it to be in compliance with all established purchasing and accounting policies.




Supervisor Approval                                                                                                           E-mail address                                          Telephone Number                             Date



Dean/Director Approval                                                              Date                                                      Authorized Institution Approval                                                      Date
                                            Attach original refund of receipts/sales credit form and supporting documentation and send to your Dean/Director's Business Office for review and approval
                                                                                          before sending to Cash Management, Suite 6101, 21 N. Park Street.




               Last updated 4/2/2011.                                                                                                                                                        edf422b4-01e8-4a57-86e8-2ac12035435f.xls

				
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