Prepayment/Deposit Request Form

Prepayment/Deposit Request Form
Instructions/Purpose: This form should be completed: When a supplier requests a deposit or prepayment
before the goods/and or services are rendered. You must create a Purchase Order (Not a Quick Order) in
RIAS to be approved by Purchasing. Once the Purchase Order is approved, complete this form, obtain the
appropriate signature, attach the invoice or supporting documentation and forward to Accounts Payable,
ASB I, Room 302, 65 Davidson Road, Piscataway, NJ 08854, Busch Campus. Or e-mail to:
Purchase Order Number:
Supplier Name:
Invoice or Reference Number: Need By Date:
Invoice/Prepayment Amount:
Reason for Prepayment/Deposit:
I hereby authorize release of this Prepayment/Deposit.
Approver’s Name (please print):
Approver’s Signature:
Campus Department & Phone Number:
Special Check Handling Instructions:
Revised April 18, 2013