f Advance of Funds Request Form Date: Amount o Advance

Accounts Payable Department
101 Braddock Road
Frostburg, MD 21532
Advance of Funds Request Form
Amount of
Advance:
Date:
Employee
Name:
Advance Type (check one) :
SS#:
Travel*
* A pre-approved travel request form is required.
Salary**
Other:
** A signed and notarized power of attorney form is required.
Purpose/Justification for Advance:
Dates of Travel/Event:
Check Needed By:
Department/Project Approval
(required for Other Advances) :
Date:
Grant Accounting Approval
(if required for Other Advances) :
Date:
Accounts Payable/Payroll Use Only:
Accounts Payable Approval
(required for all advances) :
Date:
Payroll Manager Approval
(required for salary advances only) :
Check Number:
Date:
Check Date:
EmplID:
To Be completed by recipient of funds:
By signing below, I acknowledge that I am responsible for the aforementioned funds that were
advanced to me on the check indicated above. For travel and other advances, I agree to return these
funds, or submit valid original receipts or expense forms within seven days of the end of the above
mentioned event or at the University's request, whichever is earlier. For salary advances, I authorize the
advance to be repaid from my next payroll check via a power of attorney agreement.
I acknowledge that if these funds are lost or stolen that I am solely responsible for the
repayment of these funds.
Signature of
Recipient:
Date of
Receipt:
Accounts Payable Use Only:
Date of Repayment:
AP-65/10-08
Received By: