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Warning Text %XTableStyleMedium2PivotStyleLight16`ISheet1_Sheet2]aSheet3  ;4 `i55CASH/CHECK REQUEST'ANDREWS UNIVERSITY, Berrien Springs, MIPayeeAddressID#DateApproved for PaymentDepartment Head Accountant Check one: Mail Send to: Hold(If different from Addressee)( signature required)(give name and phone # to call) Check Amto By my signature appearing below, I hereby certify that I have personal knowledge of the Payee's citizenship oro residency status and that I have asked the Payee whether he or she is a citizen or pernament resident alien of the United States.7Please give a brief explanation of what payment is for:R If this payment is for independent services, rent, royalties, honorariums etc.,H it is tax reportable to the payee and you must fill in the following:YesIf Yes provide SS#Or ITINiIf Payee is NOT a US Citizen or permanent resident, please specify the immigration status. Type of visa:DANDREWS UNIVERSITY WILL NOT ISSUE A CHECK FOR PAYMENT OF SERVICES ORCROYALTIES TO AN INDIVIDUAL OR OTHER NON-INCORPORATED ENTITY UNTIL A Signature/Person certifying above residence / visa statusPurpose of visitNoB1B2F-1J-1OtherH-1B'Who is the visa sponsoring institution?1.2.F-1 / J-1 / H-1B Departure>Current Visit: Arrival DateB1 / B2 visitors:9SOCIAL SECURITY NUMBER AND RESIDENCY STATUS ARE PROVIDED.5 Payee is US citizen or permanent residentF How many times has the payee visited the US in the last 6 months? Purpose Account # to be charged8 Information you want on check stub (15 characters max):11-2011-8910-52-201070:5 I66&8 +:u:s;cc2@ VPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V320Dq ^j Y"عuN8W_R]+ lmI *9+:O|۵Y:Iis2-#4$]䳭s B+{  W  G>    S >   [ ZZ Y XX G>   S ?  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