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Check Request Form
Submit this form with all receipts to the HRP-MN office.
Requested By: |
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Committee: |
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(Choose from the list at right.) |
Vendor invoice #: |
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(if request is for invoice payment) |
Vendor invoice date: |
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(if request is for invoice payment) |
Amount: $ |
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Date Due: |
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Description of Expense*:
*If the expense is for a program or event, be sure to include the program date below.
Make Check Payable To:
Send Check To:
Name: |
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Company: |
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Address: |
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City, State ZIP: |
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Phone Number: |
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Authorized by: |
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Code: |
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Expense Type |
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Committee |
(Choose from the lists at right.) |
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(Example: 3001-801 = Monthly meeting printing or copying.) |
*Program Date: |
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Month |
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Year |
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Date Check Written: |
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Check Number: |
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Expense Type
(Most common are bolded)
4000 – Facility Fees
4100 – Catering
4200 – Equipment
4300 – Contracted Program Services
4400 – Program Supplies
4500 – Program Advertising
4600 – Program Printing
4700 – Program Postage
5000 – Contract Administration
5010 – Contracted Services
5020 – Professional Fees
5100 – Office supplies
5200 – Telephone & Fax
5210 – Postage & Delivery
5300 – Meeting Expense
5310 – Travel & Lodging
5400 – Bank Fees
5500 – Internships
5510 – Scholarships
5900 – Donations
6100 – Insurance
Committee
100 – Administration
210 – Web Site
220 – Newsletter
240 – Public Relations
300 – Membership
310 – Directory
410 – Monthly Programming
420 – Professional Development
430 – Spring Conference
510 – College
520 – Diversity
530 – Philanthropy
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