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All Souls Unitarian Universalist Church
Check Request Form
Date of request:_____/_____/_____
Date check is needed:_____/_____/_____
Checks are written weekly. Please make arrangements if payment is needed sooner.
Person requesting check:___________________________________
Amount (total) of check:$______________ (Please make sure receipts are attached)
Description:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Make check payable to: ________________________________________
Give or mail check to: ________________________________________
________________________________________
________________________________________
________________________________________
Committee:____________________________________
Charge to: • Committee Annual Budget • Custodial Account: ____________
Chair person:________________________________________________
Check request approved:*_______________________________________
Staff/chair’s signature & date
*All disbursements or reimbursements exceeding $25.00 must be authorized by the committee chair or staff person with disbursement authority in the account description.
Account #:___________
Check date: _____/_____/_____
Check #:_____________
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