ABC City/County/Township Portal
Powered By SBS Portals
Accounts Payable Claim Application
You can submit an Accounts Payable Claim electronically by filling the fields in this form and attaching all supporting documentation (Invoices, Purchase Orders, etc.) as PDF files. If you do not have PDF files, please scan and have them on your local computer before you start filling.
Submitter Information:
Name
Department
Address
Phone
Email
Accounts Payable Voucher:
Town OF Albany Indiana
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee Name and Address
Purchase Order No.
Terms
Date Due
(mm-dd-yyyy)
Invoice 1 Date
(mm-dd-yyyy)
Invoice 1 Number
Invoice 1 Description (or note attached invoice(s) or bill(s))
Invoice 1 Amount
Invoice 2 Date
(mm-dd-yyyy)
Invoice 2 Number
Invoice 2 Description (or note attached invoice(s) or bill(s))
Invoice 2 Amount
Invoice 3 Date
(mm-dd-yyyy)
Invoice 3 Number
Invoice 3 Description (or note attached invoice(s) or bill(s))
Invoice 3 Amount
Invoice 4 Date
(mm-dd-yyyy)
Invoice 4 Number
Invoice 4 Description (or note attached invoice(s) or bill(s))
Invoice 4 Amount
Invoice 5 Date
(mm-dd-yyyy)
Invoice 5 Number
Invoice 5 Description (or note attached invoice(s) or bill(s))
Invoice 5 Amount
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received.
Date
(mm-dd-yyyy)
Signature
Click here to sign
Title
Attach Document (PDF, JPG, PNG, GIF, TIFF Only)
Enter the code here
