This payment and order authorization is used to document approval to release payment to a vendor, retailer, or other entity.
Payment & Order Authorization Form
Fields: from (institution), to, ref #, date, address, items, no, description, price, amount, total, notes/comments
You are hereby authorized to release payment to {name} or order a sum of {number} dollars
Account to be charged:
Fund ______________________________
Dept ______________________________
School ______________________________
Account no ______________________________
Authorization Raised by: (name & signature)
Approved by: (Name & Signature)
Important: A copy of the completed form should be retained for records and auditing purposes.
