Accounts Payable Express Check Form

200 Piedmont Avenue, Suite 1604 West Tower, Atlanta, GA 30334 Phone (404) 463-1993, Fax (404) 463-5089

* Requesting Agency Name:

* Agency PeopleSoft Business Unit:

* Date Requested:

* Requested by:

* Phone Number:

* Requestor's Email Address:

* Vendor Name:

* Vendor Number:

* Voucher Number:

* Voucher Amount:

Voucher Number:

Voucher Amount:

Voucher Number:

Voucher Amount:

Voucher Number:

Voucher Amount:

* Please select from the following check delivery options:

If you selected other above please give detailed information:

If pick-up is chosen, SAO will release the check to the following person:

Authorized Approver

* By selecting this box, I certify I am authorized approver, on behalf of my agency, to submit this Express Check Request Form to the State Accounting Office. I further acknowledge the voucher information entered is true in nature.

* Please add your email address to recieve a copy of your answers.

State Accounting Office Use Only

Processed By SAO:

Date:

Check Number:

SAO Form: 100-D

* Indicates Response Required