Check Request - The Arc of the Capital Area

Requested by*
First Last
Employee's Email*
Date*
MM slash DD slash YYYY
Payable to*
To whom is this amount being paid?
Special Handling Instructions:
i.e. address to be mailed, time frame, or any other necessary info
Account*
To which account is this expense attributed?
Program*
To which program is this expense attributed?
Description*
What is the specific product or service for which this amount is being paid?
Amount*
How much money is being requested?
Please enter a number from 0.01 to 1000000.
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Max. file size: 2 MB.
Attach any required receipt, invoice, or supporting documentation.