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Parking & Transportation Services

PARKING & TRANSPORTATION SVCS
TEL NO: (818) 677-2157
FAX NO: (818) 677-4747
MAIL DROP: 8290
A.S. Service Chargeback Requisition
  Use this form for Guest Parking & Special Events.
LINE
REQUIRED FIELDS:
ACCOUNT:
FUND:
DEPT ID:
PRGM:
CLASS:
PROJECT/GRANT:
REQ #:
 
REQUESTER:
DEPARTMENT:
EXT / FAX:
MAIL DROP:
DESCRIPTION: (Max 12 Char)
ESTIMATE REQUESTED:
DATE NEEDED:
Authorized Signature: __________________________________________ PRINT NAME:
Auxilary Use Only - PLEASE ATTACH COPY OF P.O.
BUSINESS UNIT:
BLANKET PO?
AUXILARY PO #:
GRANT EXPIRATION DATE:
ESTIMATED/NTE AMOUNT:
 
 
 
ACCOUNT:
FUND:
DEPT ID:
PROGRAM:
CLASS:
PROJECT/GRANT:
 
 
Auxiliary Authorization:_____________________________________ Date Approved:
Print Name:
AUXILIARY WILL BE ASSESSED A $25 LATE FEE PAYABLE TO THE SERVICE PROVIDER FOR EACH 30-DAY PERIOD BEYOND THE BILLING DATE.
Service Department Use Only
ESTIMATED COST: ACTUAL COST: DATE COMPLETED: BILLING REFERENCE: PROCESSOR:
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ENTER YOUR REQUEST HERE:
** For PTS Use Only **
Remember to fill out a "Special Event Planning Worksheet" PRIOR to requesting Parking Svcs.
  
Event / Date:

Revenue Re: (Not to exceed 5 lines)
Location:
Number of Parking Permit(s) Requested:
 


MAIL TO PARKING AND TRANSPORTATION SERVICES - MAIL DROP 8290 or FAX TO 4747.