Accounts Payable

This form is used when the department knows the vendor will not invoice Accounts Payable for payment.

This form is used when the department knows the supplier/vendor will not invoice Accounts Payable for payment.

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This field is for validation purposes and should be left unchanged.

This form is used if an additional or installment of a Purchase Order payment needs to be processed to pay for a good or service. Use this form if you know the supplier will not invoice Accounts Payable.

Please submit this form at minimum two (2) weeks before payment is due.

If more than one (1) payment required, please complete a separate form for each payment. Please note if any special handling is required.

This form is only to be used for Purchase Order payments. Send questions to acctg@bussvc.wisc.edu.

Payment notice details

Requested payment amount ($ USD)(Required)

Name of supplier to be paid(Required)

Address where payment should be sent(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Purchase Order number(Required)

Provide reason for payment(Required)

Date payment must be made by(Required)

Requester name(Required)

Requester's email(Required)

Requester's phone number

Other information/details

Special handling requirements, other important information, etc.

Attach any needed documentation

E.g., back-up documentation, wire form if paying foreign entity. Please provide all documents in a PDF format.

Drop files here or

Accepted file types: pdf, Max. file size: 10 MB.