Authorization to Pay

FSU FOUNDATION, INC.
101 BRADDOCK ROAD
FROSTBURG STATE UNIVERSITY
FROSTBURG, MD 21532-1099
CHECK NO
CHECK DATE
DATE OF ORDER
FUND NAME
ACCOUNT NUMBER
TO
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Sign the form and send the signed form to the above address
QUANTITY
UNIT
ARTICLE OR SERVICES
UNIT
PRICE
TOTAL PRICE
   
Original Receipts Must Accompany Authorization
    
 
Total Amount
FSUF Tax Exempt #
23-7120883
 
DISTRIBUTION
ACCOUNT NO. DESCRIPTION AMOUNT
     
     
     
     
     
FROSTBURG STATE UNIVERSITY FOUNDATION INC.
SIGNATURE APPROVAL
(EXECUTIVE DIRECTOR)
   
AUTHORIZED ACCOUNT DIRECTOR  TITLE DATE
ENTERED