Purchase Request Form

此表格由寻求使用资金的部门使用，由HSC财务事务或医学院院长决定。一旦审核通过，将通知相关部门。

Email Address

Request Type

IT (Speedtype) Payment Request Physical Plant (Speedtype) Print & Mail Services (Speedtype) Procard Purchase Order Stockroom Order (Speedtype) Travel (Speedtype)

Vendor

Event Date Date of event or deadline for payment

Year / Month / Day

Purchase Amount Estimated amount of purchase.

Project Code

characters remaining

Purchase Description Description of item(s) to be purchased and business purpose.

Documents Attach supporting documentation including invoices, quotes, approval communication, etc.

The Office of Finance and Administration serves all eligible faculty, staff, and students regardless of race, color, national origin, sex, disability, or age.

HSC Finance

Abell Administration Building
323 East Chestnut Street
Louisville, KY 40202

Office Hours

M - F 8:00 am to 4:30 pm

Contact

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Purchase Request Form

HSC Finance

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