How to Complete a Check Request Form

Download a Check Request Form

  1. Date — Enter the date the document is being prepared.
  2. Department Name — Enter the name of the department that is responsible for the payment.
  3. Originator Name and Phone # — Enter the name and phone number of the person who is to be called if there is a question or problem concerning the payment.
  4. Authorized Signature — Only a person who is authorized on the FOAPAL being charged can sign. If more than one FOAPAL is being charged there must be an authorized signature for each account.
  5. Bear Number Identification # — Enter the bear number, if known, of the person being paid.
  6. Vendor & Address — Enter contractor's name and a complete address.
  7. FOAPAL - Enter the FOAPAL(s) to be charged.
  8. Amount — Enter the total amount to be charged to the FOAPAL on that line.
  9. Check Stub Information — This is the information that is printed on the check stub for the contractor. Please be concise and use meaningful abbreviations.