HOTEL CARD FORM

Print and the fax completed form to Accounting Services @ 884-5572

Requestor's Name:

Requestor's Phone #:

Date:

Department Name:

Address:

Name of Hotel/Business:

Hotel Address:

Hotel Contact Person:

Hotel Phone #:

Hotel Confirmation Number:

Purpose of event:

When is the event?

Where is the event?

Who's attending (names/group):

Chartfield Information (more than one chartfield-write at bottom or attached another sheet):

MoCode Descr

MoCode

PS Acct

DeptID

Fund

Program

Project

Authorized Signer for MoCode:_____________________________________

For Accounting Use:

Date Card Used:

Initials:

Doc Received:

Reconciled:

Comments_____________________________________________________________________________________