IOC NUMBER
UNIVERSITY of CALIFORNIA, RIVERSIDE
INTERCAMPUS
ORDER and/or CHARGE
CHECK
PROPER BOX
FOR SERVICE
DATE
Initiating intercampus order and/or charge
Responding to intercampus order and/or charge
Other:
REQUESTED BY
DELIVER TO
PHONE NO.
DEPT ORDER NO.
CHARGE APPROVED BY
ROOM NO. / BUILDING / ADDRESS
LOC
DATE NEEDED
DEPT. PHONE NO.
ACCOUNT FUND SUB OBJECT OR OTHER ACCOUNT STRING
DEBIT
ACCOUNT
CODING
STRING
RECORDING/SERVICE OR BLANKET NO.
LEAVE
BLANK
DESCRIPTION – GIVE DETAILED
SPECIFICATIONS
CATALOG
NUMBER
RECEIVED BY:
DATE:
NAME OF ACCOUNT TO BE CREDITED
CREDIT
ACCOUNT
CODING
STRING
UNITS
ORDERED
UNITS
ISSUED
DEPARTMENT TAG NO.
UNIT
PRICE
AMOUNT
TOTAL
LOC ACCOUNT FUND SUB OBJECT OR OTHER ACCOUNT STRING
CONTACT PERSON:
PHONE #:
Complete this form and obtain appropriate approval. Send completed form to UCR Accounting Office.
RETN: OFFICE OF RECORD: 10 YRS SUBJECT TO CONTRACT & GRANT REQUIREMENTS. OTHER COPIES: 1 YEAR