Mason Bookstore Charge
Barnes & Noble
Accounts Payable
MSN: 3C1
Tel: 3-2580; Fax: 3-2589
Delivery Information
Department Information
Deliver To:
_________________________________
Department Name _________________________________
Building:
_________________________________
Phone: _______________Fax :_____________________
Room #:
_________________________________
Fund or Org(s) to be charged: ________________________
Phone: __________________MSN:
_____________
Account Code ____________________________________
Activity Code (requires preapproval) __________________
Contact Person: _________________________________
Item
Number
Description of Items/Services Desired
May Not be Used for Gift Card Purchases
Quantity
Unit Price
Total Purchase Amount
Purchase
Amount
0
Approval Signature
___________________________________________________________________________________________
Signature of Approving Official for Fund/Org
Print Name
Title
Date
A copy of this form should be retained by the requesting unit.
May 2013