Statement of payee/requester responsibilities (if requesting employee or student reimbursement, signature is required)
I certify that this expenditure is reasonable and necessary for the department's operations and the University's mission.
Statement of Appropriate Administrator/Approver Responsibilities
I certify that the funds are available for this expenditure and that this expenditure is reasonable and necessary for the dept.'s operations and the University's mission.
Attach all receipts, invoices and supporting documentation to this Direct Payment Request form and submit to Accounts Payable: LBCMP/LBFDN/LB49R - University Controller's Office Accounts
Payable,Foundation Building Suite 280 (MS-9901), 6300 State University Drive, Long Beach CA 90815 Phone: (562)985-2512. Form Rev. Date: 2017-04