Payment Requisition Form

Instructions:
1. Initiator/department to complete all form fields below and seek approval from supervisor. Clear Form
2. Original invoice and appropriate supporting documentation must be attached.
3. Submit completed form and documentation to Accounts Payable. Print
Notes:
- Completed form and supporting documentation due by Monday at Noon for inclusion in weekly Friday cheque run.
- Standard distribution is by regular mail. Provide reason/details in ‘Other Notes’ if requesting Courier /Pick Up/Rush.
- Advance payment or pre-payment is normally not allowed and must be specifically approved using a separate form.
- Remuneration may only be processed through payroll.
- Incomplete forms will be returned to the preparer for correction. Prepared by: Narmatha Vannarajah

Vendor/Payee Name Distribution

Mail EFT Pickup Rush?
Narmatha Vannarajah
PAY TO Default Use ‘Notes’ to explain
Address City Prov Postal Code

31 Oakden Crescent Toronto ON M4J 4H8

REASON FOR Describe the good or service being purchased; attach supporting documentation
PAYMENT Presto Pass - October 2023
Account Cost Centre
Additional Description Invoice Total
(5 digits) (Department)
62000 114 - Respite Staff Metro Pass - October 2023 124.80
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Total 124.80
OTHER NOTES/
COMMENTS

Name
Approved by Signing Authority: (please print) Janet Reyes
Cannot be same as Vendor/Payee identified above.
Signature
I hereby certify that I am authorized to sign on the cost
centres above and that all expenditures are valid, in
Title and Dept Sr. Manager - 24 Hour Respite
compliance with the policies of Fred Victor, and
sufficient funds are available to cover this expenditure.
Date 09-Nov-23

Finance Department Use Only:

Vendor Number Checked by Date Notes

Questions? Contact Firoj Shah at 416-364-8228 x 1387 or accountspayable@fredvictor.org

Fred Victor Version

Finance Department – Accounts Payable 2017.04.19