California State University, Bakersfield - Financial Services

California State University, Bakersfield - Fiscal Services

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Please use the "Print Form" button at the bottom, and not Ctrl+P. Send Billing Request form and supporting documentation to Accounts_Receivable@csub.edu.

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California State University, Bakersfield
Fiscal Services

210249

Requested By:

Date:

Name:

Business Unit:

Department:

Extension:

Description of Services or Charges including Date(s):

On Campus Billing:

Project Name:

Billing Request Form

Department:

Invoice: Credit Memo:

Total Amount Due:

Chart Fields to be Charged:

Business Unit:	Fund:	Department:	Account:	Program:	Project:	Class:	Amount:
Charged business unit 1	Charged Fund 1	Charged Department 1	Charged Account 1	Charged Program 1	Charged Project 1	Charged Class 1	Charged Amount 1
Charged business unit 2	Charged Fund 2	Charged Deprtment 2	Charged Account 2	Charged Program 2	Charged Project 2	Charged Class 2	Charged Amount 2
Charged business unit 3	Charged Fund 3	Charged Department 3	Charged Account 3	Charged Program 3	Charged Project 3	Charged Class 3	Charged Amount 3

Chart Fields to be Credited (revenue):

Business Unit:	Fund:	Department:	Account:	Program:	Project:	Class:	Amount:
Credited business unit 1	Credited Fund 1	Credited Department 1	Credited Account 1	Credited Program 1	Credited Project 1	Credited Class 1	Credited Amount 1
Credited business unit 2	Credited Fund 2	Credited Fund 2	Credited Account 2	Credited Program 2	Credited Project 2	Credited Class 2	Credited Amount 2
Credited business unit 1	Credited Fund 3	Credited Department 3	Credited Account 3	Credited Program 3	Credited Project 3	Credited Class 3	Credited Amount 3

Printed Authorizing Signature:

Printed Signature1

Authorizing/approving Signature:

Off Campus Billing:

Project Name:

Company Name:

Department:

Phone (required):

Total Amount Due:

Attn: (required):

Mailing Address:

City:

State:

Zip Code:

Bill-To Email Address (required):

Business Unit:	Fund:	Department:	Account:	Program:	Project:	Class:	Amount:
Off campus business unit 1	Off Campus Fund 1	Off Campus Department 1	Off Campus Account 1	Off Campus Program 1	Off Campus Project 1	Off Campus Class 1	Off Campus Amount 1
Off campus business unit 2	Off Campus Fund 2	Off Campus Department 2	Off Campus Account 2	Off Campus Program 2	Off Campus Project 2	Off Campus Class 2	Off Campus Amount 2
Off campus business unit 3	Off Campus Fund 3	Off Campus Department 3	Off Campus Department 3	Off Campus Program 3	Off Campus Project 3	Off Campus Class 3	Off Campus Amount 3

Printed Authorizing Signature:

Printed Signature2

Authorizing/approving Signature:

Department instructions:

Supporting Documentation (i.e. faculty, rental contract etc.) is required.
For questions, please contact Accounts Receivable at extension 3975.
Send Billing Request form and supporting documentation to Accounts_Receivable@csub.edu

Copy of Invoice to:

California State University, Bakersfield - Fiscal Services

Printing Notice:

California State University, BakersfieldFiscal Services

California State University, Bakersfield
Fiscal Services