Request for Payroll Payment

St. Andrews Episcopal Church   o   406 Hillsboro Avenue   o   Edwardsville, Illinois 62025

 

 

Payee Name           __________________________________

 

Payee’s address:          __________________________________

 

                                    __________________________________

 

                                    __________________________________

 

Payee Social Security # (if appropriate as described below):

                            

                             _____________________________

 

Note: SS# is required if this payment is to an individual for $600 or more OR

total payments to this individual for the current fiscal year are anticipated to total $600 or more.

 

Total Amount of Check:                    $______________

 

                Check amount to be charged to budget line(s) as indicated below:

 

                        Supply Organist                        $__________________

 

                        Supply Priest                $__________________

 

                        Other___________            $__________________

 

Date and description of services provided by payee:

 

_______________________________________________________________________

 

Comments:

 

_______________________________________________________________________

 

Requested by: ___________________________________ Date ___________________

                                       (Print your name)

 

Signature of Requestor: ___________________________________________________

 

Signature of Approver (see below): ___________________________________________

 

Note: Approver signature required if Requestor does not have authority to sign for a church budget line.  Normally, an Approver is the individual responsible for the budget line(s) charged for this payment.  When appropriate, the Rector or Wardens may sign as the Approver.

 

                                               

Payment will be made through Metavante, the contractor responsible for Partners Bank Bill Pay service, on the basis of an online request made by Cindy Yelverton, St. Andrew’s Assistant Treasurer. The Payee will normally receive the check from Metavante no later than 7-10 days from the date the Assistant Treasurer receives an accurately completed request.  Cindy Yelverton can be contacted via email at moolover@hometel.com.

 

--------------------------------------------------------------Office use only---------------------------------------------------------------------------------

 

Date Paid: _____________________     Transaction No.:_______________________        Paid By: __________________________