Post-Award Finance
the PAF team

Post-Award Finance... Customer Code

Request Form for Customer ID Code

Use this form to request Customer ID codes or update an existing code for accounts receivable or invoice transactions.

Instructions:

Fill in the blanks with the appropriate information. At the end of this form, print it out and fax this information to the PAF Team at 713-500-4939.

Required fields are marked with **

Mark if new request:

Mark if change request:

Provider/Customer Information:

**Provider/Customer Name: (max. 10 characters)

** Recommended Short Name: (max.10 characters)

**Address Line 1:

**Address Line 2:

**Address Line 3:

** City: **State:

**Zip code: Country:

Provider/Customer Telephone Number:

Provider/Customer Fax Number:

**What is the reason for the request?

Your Information:

**Type name here:

Inter-institutional address:

Your Telephone Number:

** Your Fax Number:

Email username @ email Server
@

** Your E-mail address:

Additional Information:

Administrative Use Only:

Location Sequence: (three numeric characters)

Location Description: (maximum 30 characters)

Entered/Updated By:

Date:

 

The University of Texas Health Science Center at Houston
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Last updated January 30, 2009
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