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Accounts Payable Forms
Accounts Payable
Tel No (818) 677-3472
Fax No: (818) 677-4581
Mail Drop: 8202
Petty Cash Reimbursement Request
Total $50.00 or less, Excluding Tax
EMPLOYEE NAME: DATE: CSUN EXTENSION:
DEPARTMENT NAME: REQUISITION NO:
I. DESCRIPTION: AMOUNT:
$
$
$
$
$
$
      
 $
II. ACCOUNTING DISTRIBUTION:
ACCOUNT:
FUND:
DEPT ID:
PROGRAM:
CLASS:
PROJECT/GRANT:
AMOUNT:
III. INSTRUCTIONS:
1. WHEN TO USE THIS FORM: THIS FORM IS TO BE USED TO REIMBURSE AN INDIVIDUAL WHO IS ASSOCIATED WITH CSUN, (FACULTY/STAFF), FOR PURCHASES THAT THE INDIVIDUAL HAS ALREADY MADE ON BEHALF OF THE UNIVERSITY. MILEAGE LESS THAN $10.00.
2. WHEN NOT TO USE THIS FORM: DO NOT USE THIS FORM FOR REIMBURSEMENT OF:
1. TRAVEL & ENTERTAINMENT,
2. GIFTS OR ITEMS OF A PERSONAL NATURE
3. WHO MUST APPROVE: THE "AUTHORIZED SIGNERr" MUST BE THE PERSON AUTHORIZED TO SIGN FOR THE FUND/DEPTID(S) LISTED ABOVE. HOWEVER, IF THE AUTHORIZED SIGNER IS THE PERSON TO BE REIMBURSED, THE NEXT HIGHER AUTHORITY MUST SIGN AS "AUTHORIZED SIGNER".
4. WHAT TO SEND: THE ORIGINAL OF THIS FORM, ALONG WITH THE ORIGINAL INVOICE(S) TO BE REIMBURSED. THE ORIGINAL INVOICE(S) MUST:
1. BE IMPRINTED WITH THE VENDOR'S NAME
2. BE ITEMIZED
3. HAVE A DETAILED DESCRIPTION OF THE ITEM
5. WHERE TO SEND THIS FORM: DELIVER IN PERSON TO:
UNIVERSITY CASH SERVICES
BAYRAMIAN HALL BH100R
Between 8:30-4:00pm, Mon-Fri
ARROW POINTING RIGHT PERSON RECEIVING CASH MUST BRING FACULTY OR STAFF IDENTIFICATION.
LINE
PERSON REQUESTING REIMBURSEMENT:  
Employee Signature: ______________________________________ Date: ________________
Employee Title: ___________________________________  
APPROVAL BY:  
AUTHORIZED SIGNER: ______________________________________ Date: ________________
PRINT NAME:  
Please print double-sided and return this form to Accounts Payable, Mail Drop 8202
LINE
FOR UNIVERSITY CASHERING USE ONLY:
CASH GIVEN TO: (Please Print) SIGNATURE: ___________________________
AMOUNT PAID: $
Date: ________________