Income Fund Reimbursable - Invoice Change Notice


Project Director: Date:
Campus Address:
Account Number:
Invoice Number:

Original Amount Due $
Adjustment Increase (+) $
Adjustment Decrease (-) $
New Total Due for this Invoice $


Reason for Adjustment (explain below):
* * * * * * * * * * * * *
Accounting Office Use Only: (all 4 copies of this form should be sent to the Accounting Office)


____ Adjustment Approved
____ Adjustment Disapproved (Explanation: _______________________)

Distribution
White - Issuing Office / Yellow - Issuing Office / Pink - Accounting Office / Goldenrod - Bursar's Office



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