Check Request Form

Cincinnati Church of Christ
CHECK REQUEST FORM

Make check payable to:________________________________________________________

Address:*_____________________________________________________________________

City_____________________________________State___________Zip Code_____________ *Request will not be processed without complete address above, or on attached receipt.

`Amount:$___________`	`Distribution of Check`	`____ Mail to Above Address`
		`____ Keep at Office`
		`____ Other_________________________`

Purpose of Check* *Include all applicable information such as vendor name, type of goods or services provided, sector that incurred expense, etc.

______________________________________________________________________________

Sector________________________________________________________________________

Receipts Attached: ___Yes ___No* If no please explain:_____________________

______________________________________________________________________________

______________________________________________________________________________ *Checks will not be issued to any individual without a valid receipt\explanation.

Person Placing Request: _________________________________ Date:______________

Church Leader/Admin. Approval:*__________________________ Date:______________ *Request will not be processed without required approval signitures.

Accounting Use Only
DATE REC'D ( ) TOTAL $___________
APP'D BY ___________________________ DATE ___________
CK# _______________\___________ VO#_______\_______
A/C# _______________\___________ Amount$__________|____
A/C# _______________\___________ Amount$__________|____
A/C# _______________\___________ Amount$__________|____
A/C# _______________\___________ Amount$__________|____
A/C# _______________\___________ Amount$__________|____

V3.0 1/1/97

Cincinnati Church of Christ CHECK REQUEST FORM

Cincinnati Church of Christ
CHECK REQUEST FORM