FOREIGN/INT'l DRAFT
TO:
+4 ZIP:
DELIVER
TO:
FORM LETTER INVOICE RECEIPT
ITEM QUANTITY
68%727$/
1
2
3
4
ZIP +4 PHONE EXT. DATE AMOUNT
DATE
DATE
DEPT
BLDG/RM #
+4 ZIP
Company/Vendor Name:
Complete Address (Including Postal Code):
CITY, STATE, ZIP
CODE
ADDRESS:
DELIVERY DATE:
RETURN FORM TO:
NAME OF VENDOR
PAYABLE TO:
MAILING ADDRESS
SUPERVISOR(S)
Reference:
TOTAL AMT
NOTES:
DESCRIPTION OF ITEM IN ENGLISH / PURPOSE OF FOREIGN/INTERNATIONAL WIRE TRANSFER
,7(0PRICE
INDEX CODE/ACCOUNT
TOTAL
SIGNATURE OF INITIATOR
FORWARD TWO COPIES TO TREASURER'S OFFICE, ST. MARYS 301, (+1640). DEPARTMENT RETAINS ONE COPY.
CONCURRENCE(S)
FOREIGN/INT'l DRAFT REQUEST
UNIVERSITY OF DAYTON
TREASURER'S OFFICE
DAYTON, OHIO 45469-1640
TELEPHONE
FEDERAL I.D. NO./SOCIAL SECURITY NO.
A
P
P
R
O
V
A
L
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00