Check Request Form
Reimbursement Payment To vendor
Please Make Check Payable To:
Name:CHECK HERE IF REIMBURSEMENT IS FOR JOURNAL (not an individual)
(check will be made payable to signer on the journal’s external checking account)
Email:
If you have Electronic Funds Transfer set up with the University,
your reimbursement will be automatically deposited into your checking account.
If an email address is provided, you will be notified when that has taken place.
UC Student ID #: / OR / Social Security # or Tax ID #:
Journal: (check one)
California Law Review / Berkeley J of International Law
Ecology Law Quarterly / Berkeley J of Gender Law & Justice
Berkeley Technology Law Journal / Berkeley J. of African-American Law & Policy
Berkeley La Raza Law Journal / Berkeley Business Law Journal
Berkeley J of Employment & Labor Law / Asian-American Law Journal
Berkeley Journal of Criminal Law / Berkeley J of Middle Eastern & Islamic LAw
Description of Payment:
/Amount: / $
Charge to:
Other : / (Special instructions, ie. should be paid from Symposium Acct.)
otherwise chartstring will be filled in by Kira:
Submitted by: / Date:
Journal Editor Signature
Approved by: / Date:
Meg Garstang, Accounting & Business Manager
Note: Please TAPE All Original Invoices And Receipts To 8 ½ X 11 Inch White Paper.
07-07 REV