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Brown Home Brown Home Brown Home Brown Home Brown Home Brown Home

Form Name:


Used for:

  • Notification to Accounts Payable that part of an order has been received and is authorized for payment.

  • Approving interim payments on a purchase order for work performed by independent contractors.

Required Fields:

From Department: Department name.
Firm name: Name of the vendor.
Purchase Order #: Use format Pxxxxxx.
Quantity & Description: List items received in the same line item format as is on the Purchase Order.
Date & Signature: Date items are received and signature of authorized department representative.

Documents to Attach:

None required.

Where to Send:

Send form to Accounts Payable, Box, J.

How to Obtain:

Form is stocked in University Stores, reference #60260. Use Stock Issue Slip form to order.

download available

Special Notes:

  • None