Payment Request Staff requests for payment via bill.com; this will issue a check or e-payment. Your Name:(Required) First Last Your Email:(Required) Payable to Name (organization or person) Vendor Email Address to send payment IF NEW VENDOR REQUIRED FIELD Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Amount requestedExpense Category (G/L Code)(Required) Class(Required) Purpose of payment (provide as much detail as possible, what program, event, mileage, etc.)Date payment needed MM slash DD slash YYYY Upload any relevant files-if new vendor add W9 here-required to process paymentMax. file size: 128 MB. Δ
