Systems and Procedures
A Division of The Corporate Controller's Office


Form Instructions

  1. If required, enter the Social Security number (Central Use Only).
  1. Enter name and current mailing address of payee.
  2. Enter the city, state, country and postal code.
  3. Enter the department reference number, if desired. (If the area is using Financial IBIS "FANS," this space may be used instead for fiscal year and department free space notations.)
  4. List department number, fund name, fund number, and object classification.
  5. If applicable, enter the project number, or cost center if using "FANS."
  6. Insert the amount and currency to be paid. If an explanation is required, indicate "see below" in this block and type the explanation in the "Explanation Block" below.
  7. Insert the statement "*** LAST ITEM ***" immediately after the last line item to indicate that items appearing above this statement are authorized items, and any items added below this statement are invalid.
  8. Mark appropriate instructions to Accounting Operations.
  9. Give adequate explanation to expedite approval.
  10. In the event that there are any questions, provide contact name, phone number and email address.
  11. Obtain the required approvals. (See Policy FN18)
Image of Special Request for Check Form