Orinda Community Church

Requisition Voucher

DATE:____________________

CHARGE TO: _______________________ (line account with a letter and a number -- see Chart of Accounts

NAME OF LINE ACCOUNT:_____________________________________

COMMISSION OR ACTIVITY:________________________________________

Circle One:  PURCHASE OR ACTIVITY

DETAILED DESCRIPTION:______________________________________________________________________

______________________________________________________________________________________________

AMOUNT: $ ___________ Attach receipts which acount for the total amount requested

CHECK PAYABLE TO: ___________________________________

MAILING ADDRESS:___________________________________________________________________________

OTHER INSTRUCTIONS:_______________________________________________________________________

AUTHORIZED BY: _____________________________________________________________________________