Finance Approval Request

FINANCE APPROVAL REQUEST

Request Summary

Request Date:    Requestor Name:

Request Type & Funding

Request Type: Capital Expenditure Operating Expense Invoice / Vendor Payment Travel / Reimbursement

Vendor / Payee Information

Vendor Contact:    Payment Terms:

Cost Breakdown (if applicable)

Subtotal:    Tax:    Shipping / Fees:    Total:

Justification & Compliance

Procurement Required: Yes No    Competitive Bids Obtained: Yes No

Invoice or Quote Executed Contract Purchase Order Budget Approval Business Case

Risk, Terms, and Certification

By submitting this request I certify that the information provided is true, accurate, and complete to the best of my knowledge; that funds are available or will be secured for the requested expenditure; and that this expenditure complies with organizational policy and any applicable contractual or regulatory obligations. I authorize the Finance Department to post charges to the specified GL account and to take necessary actions to process payment.

I understand that false statements or misrepresentation may subject me to disciplinary action and may require repayment of disallowed amounts. I agree to retain and provide supporting documentation upon request for audit and compliance review.

Approval Matrix (For Approvers: check decision and provide printed name)

Finance Use Only: Budget Available? Yes No    Encumbrance Required: Yes No

Certification by Requestor

I hereby certify that the expenditure is necessary for official business, that procurement and contracting procedures have been followed where applicable, and that I will provide all required supporting documentation to Finance and Audit upon request.

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