Advance Payment Request Form

Company/Organization Name

XYZ Corporation

Form Reference Number

APF-2023-001

Date of Request

December 20, 2024

Requestor Information

Name of Requestor: John Doe
Employee ID: 12345
Department: Finance
Contact Details:

• Phone: +1-234-567-8901
• Email: john.doe@xyzcorp.com

Payee Information

Name of Payee: Jane Smith
Contact Details:

• Phone: +1-987-654-3210
• Email: jane.smith@xyzcorp.com
  Bank Details (for Transfer):
• Account Name: Jane Smith
• Bank Name: ABC Bank
• Account Number: 123456789
• IFSC/Swift Code: ABCD0123456

Advance Payment Details

Amount Requested: $5,000
Currency: USD
Reason for Advance Payment: Purchase of office supplies for Q1 operations.
Expected Date of Settlement: January 10, 2025

Supporting Information

Attached Documents: Purchase Order #PO-2023-789, Vendor Quotation

Authorization Section

Requested By:

• Name: John Doe
• Signature: _______________________
• Date: December 20, 2024

Approved By:

• Name: Emily Carter
• Signature: _______________________
• Date: December 21, 2024

Remarks/Comments

Advance requested to meet urgent operational needs.