A check requisition form records a request to issue a payment before a check is prepared. This free Word template gives a requester space to state the amount, payee, purpose, delivery instructions, budget or account, and approval. It is designed around a committee’s internal payment process and can be adapted for another organization.
Download format: one editable DOCX file. “Cheque requisition” is another spelling for the same kind of request; the downloaded form itself is titled “Check Requisition Form.”
The one-page layout has sections for the date requested and needed, person requesting, amount and description, payee and check delivery, committee and budget coding, chairperson and approval, plus account and issued-check details.
Open the file in a compatible word processor to edit, then print or share according to your organization’s process. Review its sample instructions before using it.
What is included in the form?
Section
Information to enter
Request timing
Date of request and date the check is needed
Requester and purpose
Person requesting the check, total amount, and description of the expense or reimbursement
Payee and delivery
Who the check is payable to and who should receive it by hand or mail
Internal coding
Committee, annual budget or custodial account, chairperson, and account number
Authorization and issuance
Approver’s signature and date, check date, and check number
How to complete a check request
Identify the request. Enter the request date, needed date and requester’s name. Allow enough time under your own finance team’s processing schedule.
State the payment. Write the exact amount, a short reason for payment and the payee’s correct legal or business name. If the check will be mailed, give the person processing it a verified delivery address through your normal secure channel.
Attach support. The template asks for receipts. Attach the invoice, receipt or other supporting document your organization requires, and avoid paying the same expense twice through a different workflow.
Choose the correct account. Enter the committee and account details and select the relevant budget or custodial-account option. An organization without those categories should rename the fields before distributing the form.
Obtain authorization. Route the request to the person authorized under your organization’s policy. Finance staff can record the account number, check date and check number after the payment is issued.
Example: A committee requests a $145 check to reimburse an approved event-supply purchase. The requester enters the amount and description, attaches the receipt, names the employee as payee, chooses the appropriate budget, and sends the form for the required signature. The finance team later records the issued check details.
Adapt the sample policy before using it
The downloadable form says checks are written weekly and includes an authorization note for disbursements or reimbursements over $25. Those statements belong to the sample form; they are not universal processing times or approval thresholds. Replace them with your organization’s actual schedule, approval limits, roles and recordkeeping rules. Also update the committee and custodial-account labels if they do not fit your finance process.
The document uses Word drawing and text-box elements for its layout. After changing field names or policy text, check that the page still prints clearly and that signature and amount lines have enough room. Keep completed requests and supporting documents in the approved finance system rather than treating the blank template as the payment record.
Frequently asked questions
Is this a check or a request for one?
It is an internal request and approval form. Completing it does not issue a check or prove that a payment has been made.
Can I use the template for reimbursements?
Yes, when your organization handles reimbursements through check requests. Name the employee as payee, describe the business expense, attach required receipts and follow your approval policy.
Does every request above $25 require a committee chair’s signature?
No. That amount and approval route are printed on the sample. Change the note to match your own authorized policy before use.
What if we pay electronically instead of by check?
You can adapt the payment and delivery labels, but the existing fields specifically refer to a check date and check number. A general check request form collection may offer a layout better suited to your workflow.
