CHECK REQUISITION REQUEST

 


This requisition form is to be used by Lewinsville Presbyterian Church members who are working with Ministry Groups, Committees and other groups in service to the church. Final approval rests with John Bean, Church Administrator

If you have questions about this form or the check requisition process, please call John Bean at the church office, 703-356-7200 during normal business hours.

Your Name:

Phone:

Email Address:

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Please cut check payable to:

Address - Line 1:

Address - Line 2:

City: , State: (2-letter abbreviation) Zip:

Total Amount of Check: $ (x,xxx.xx)

Purpose / Memo Note:

Account to be Charged:

Account Name:

Account Number:

Authorized by: (Committee Chair)

Authorized Date: (Month/Date/Year: xx/xx/xxxx)

Check Instructions:

Write Check Now
Wait for Invoice

Special Instructions:

Please note: The "Thank You" page which appears after submitting this form is your assurance that the form has been received. If for some reason you are not taken to this page, please re-submit this form. Thank you.

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