Payment Authorization Form

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PAYMENT AUTHORIZATION FORM

____________________________
PTA
LeConte

Date ________________________

Name of Person Requesting Check ________________________________

Telephone (______) ____________

PTA Position __________________________________________________

City/Zip ______________________

Event or Assignment ___________________________________________________________________________


Date of Event _________________________________

Date Approved in Minutes ________________________


r Invoice attached

Amount Requested $ ________________________

r Receipt attached

Write Check To:

Name of Person/Company ______________________________________________________________________

Address ____________________________________________________________________________________

_________________________________________________________________ (_______) _________________


City

Zip

Approved by:

_____________________________________________
Presidents Signature

FOR PTA TREASURER

USE:

r Membership-approved activity

r Executive Board-approved expenditure


Budget Category

Telephone

_________________________________________
Secretarys or Financial Secretarys Signature

r Funds released by membership

Budgeted Amount

Check Number

Amount

California State PTA Toolkit - 2009

329

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