This form must be completed in one sitting and cannot be saved to complete later.

Choose your Department/Org # (in 1 of the 3 drop downs)
Please just choose one department from the lists.
Please attach a copy of a completed IRS W-9 Form. See the IRS W-9 Form button at the top of this form.
Files must be less than 32 MB.
Allowed file types: bmp eps tif pict txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods xml.
Files must be less than 32 MB.
Allowed file types: bmp eps tif pict txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods xml.
$
$
$
If no, please see the International AP Payment Matrix button above for additional documents required.
Warrant delivery
Select one: If selecting wire transfer; Please include a completed Wire Payment Request form, see the button at the top of this form.
Payment Purpose
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