Milford United Methodist Church
Milford, New Hampshire
REQUEST FOR PAYMENT
Date: _______________________
To: Treasurer
From: ________________________
For: ______________________________________________
______________________________________________
______________________________________________
______________________________________________
Amount of Request: $_____________________________
Pay to: _________________________________________
_________________________________________
_________________________________________
Account to be charged: ______________________________
Approved: _________________________________________
(Program Area)
Approved: _________________________________________
(Finance Chair)
Check No: ____________
Date Paid: ____________