IFR Customer Input Form

This form provides the Accounting Office with the customer information needed to establish a client in the Income Fund Reimbursable (IFR) Billing and Receivable Module.

Customer Name:

Address Line 1:

Address Line 2:

Address Line 3:

City:

State:

Zip:


Input Provided By:

Name:

Email:

Unit:

Campus Address:

Campus Phone: