Controller's Office
Invoice Payment Request Form
Date:
*Attached Invoice Required
Vendor Name:
Vendor CWID:
Invoice Number:
Purchase Order:
(if any)
Index:
Account:
Approver Name (print)
Title
Signature
Date
If grants are charged:
ORA Approver Name (print)
Title
Signature
Date
Comments:
Note: Goods and services payments greater than $5,000 require a Purchase Order. If the Purchase Order number
is provided, no need for the index and account information. ORA approval is also not necessary in this case.
AP Use Only:
Banner Doc #:
Processed By:
Date:
Approved By:
Date:
Revised 9/18/17

Document Outline