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  • Receipt For Services

    Încărcat de

    rajeshmanam
    4 vizualizări1 pagină
    Signature of recipient: signature of recipient: under penalty of perjury, I certify that for the purposes of reimbursement, the items and totals listed herein are proper charges for services rendered. Signature of Faculty coordinator: Signature of Faculty coordinator.

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    Receipt for Services

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    © Attribution Non-Commercial (BY-NC)

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    Signature of recipient: signature of recipient: under penalty of perjury, I certify that for the purposes of reimbursement, the items and totals listed herein are proper charges for services rendered. Signature of Faculty coordinator: Signature of Faculty coordinator.

    Drepturi de autor:

    Attribution Non-Commercial (BY-NC)
    Descărcați ca PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    4 vizualizări1 pagină

    Receipt For Services

    Încărcat de

    rajeshmanam
    Signature of recipient: signature of recipient: under penalty of perjury, I certify that for the purposes of reimbursement, the items and totals listed herein are proper charges for services rendered. Signature of Faculty coordinator: Signature of Faculty coordinator.

    Drepturi de autor:

    Attribution Non-Commercial (BY-NC)
    Descărcați ca PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    din 1

    Receipt for Services Receipt for Services

    Faculty Coordinator: ____________________________________ Faculty Coordinator: ____________________________________

    Location: _____________________________________________ Location: _____________________________________________

    Date: ________________________________________________ Date: ________________________________________________

    Amount/currency of payment: _____________________________ Amount/currency of payment: _____________________________

    Paid to: _______________________________________________ Paid to: _______________________________________________

    For the following services: ________________________________ For the following services: ________________________________

    ______________________________________________________ ______________________________________________________

    ______________________________________________________ ______________________________________________________

    ______________________________________________________ ______________________________________________________

    REQUIRED SIGNATURES REQUIRED SIGNATURES

    Signature of recipient: Signature of recipient:

    ______________________________________________________ ______________________________________________________

    Under penalty of perjury, I certify that for the purposes of Under penalty of perjury, I certify that for the purposes of
    reimbursement, the items and totals listed herein are proper reimbursement, the items and totals listed herein are proper
    charges for services rendered. charges for services rendered.

    Signature of Faculty Coordinator: Signature of Faculty Coordinator:

    __________________________________________________________ __________________________________________________________

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