ࡱ> 574Y  bjbj[[ 49 \9 \ff.wyyyyyy$>~-/// w/w///8,/c0/rr/r/4/% rf> :   SOUTHERN UNIVERSITY RESPONSIBILITY FORM o Department Invoice o Purchase Order Department Invoice# _________________ Amount> ______________ Purchase Order# __________________ Amount> _______________ Payable to: ___________________________________________________ I, _____________________________________ do hereby assume responsibility for returning original invoice/receipts and all documentation within five (5) working days from the receipt of the vendor check. I will return the original receipts signed by me acknowledging the receipt of goods/services. If the event has already taken place the invoice with my signature must be submitted to the Businesss Office Accounts Payable Section for final processing, at which time a check will be mailed to the vendor. In the event that the receipts are not returned as agreed, I hereby authorize the Businesss Office to deduct from my payroll check the above amount to clear this responsibility form. _______________________________ _______________ Signature Date _______________________________ ________________ Social Security Number Phone# ___________________________________ _________________ Approval Accounts Payable Supervisor/Designee Date Due date for the return of receipts/documentation __________________________. If the receipts/documentation are not returned by the due date the above paragraph will go into effect. NOTE: A copy of the purchase order should be attached if mailed. Hrtv* . P n ( ) Q ! $ T ` } #%&-vúϺϮԦԦԦԦԟԗϗԗϗϗԗϟhNfhwCJaJhNfhw5CJaJhNfhw5 hNfhwh;%>hw5h?Ihw5CJaJhw5CJ8aJ8h?Ihw5CJ8aJ8 hw5hw5CJaJhh(hwB*phjhh(hwB*Uphhi[hw2FHprN P ' ( Q R  | } -.v &d P gdw$a$gdwgdwFGYZ   gd?I$ 00]0^0a$gdw$a$gdwgdw     hNfhNf5hNfU hw5 hNfhwhw PV# ___________________________ Date Mailed _________________________ Special Approval: ________________________________________________ __________________ Fiscal Officer Signature Date 21h:pNf/ =!"#$%  Ddaa ||D  3 A"`b I0lPX D n I0lPX PNG  IHDR^^ S\sRGBPLTESb_}G@8(0 anWo{O(=w6JoDVg(>7KEXSebqbrp~p~ǩϩϷ׷1,,BBXXnn{=HS^it,BXn̚װ{{,BXn={HS^it,BXn{,,BBXXnn{=HS^it,BXn̰{{,BXnV{dr,BXn+{29@GNUc,qBXn{,,BBXXnn={HS^it,BXn̚װ{{,BXn{=HS^it,BXn3)G8aEsO$\)c+i+p0̇GԏWۜix賌Ĝϰd! pHYslIDAThCYV9 4@(aiJ-ɞX8tag3c1ҍ<00{&Vװ!V\a2QuvJ"_yiE<|]t+ʯE,zy _gJGooK/z!G% F}x_TW˧e>ՙٝ¡H01ZXjU֞ Ux;(UV=tq [:m(Rd*TxM@ztyWCLqeuM`FRZt)'o-Dȑrlj UI|M(= Ǟ1S]W{&d3!a*N!.U&A|?2y< W"JcH;dPT~zz.r YBD 9S&YW"_xjB<m S[ȏG*/߻ N5j!8/UC^PoĠ:x~QODiJN,kvnڼY+dVk^wnÓ?)@_KCe| 퀂襨$ p1ⰕxL+Y[AȓSVxSjZ vZW #|Xs"]Zp,-%em> /P|UNԩ;GQWN,8HEtM;+ue'hu,<<}{l81%R'5$t{xw5dJF x6/NҸNw)\I2@l>Zw>E6{#~ -fO#xzw^6eBXTU{X]d`U[X7b;:OC~󵟍Բk!/J>I6\ k1рGD? g~)]CQJQ]GItTȀO`R_+V8~dJ5{!}EH0D@ =fz +*"n>(63 W ѩt)M-^'zYω|,$Җ2>c6v%:mm)nHdŮcqKpECx%ŷ2Rn6"9==rT6r*].h5mMUt L߁Zc~k|=.W'~m\3ǡGIˠSKvOmA.mEhk֚DgDVM(>); DsnBOڛEBjCTF\iUf<>d2XѡwڷmJq0a6n3+.,ug1$&!ۛ̈9@l饃zG 1ˆ˵I̗0"#w(a1,ns| :<=* ˅|M;GvnB`2ǃ,!"E3p#9GQd; H xuv 0F[,F᚜K sO'3w #vfSVbsؠyX p5veuw 1z@ l,i!b I jZ2|9L$Z15xl.(zm${d:\@'23œln$^-@^i?D&|#td!6lġB"&63yy@t!HjpU*yeXry3~{s:FXI O5Y[Y!}S˪.7bd|n]671. tn/w/+[t6}PsںsL. J;̊iN $AI)t2 Lmx:(}\-i*xQCJuWl'QyI@ھ m2DBAR4 w¢naQ`ԲɁ W=0#xBdT/.3-F>bYL%׭˓KK 6HhfPQ=h)GBms]_Ԡ'CZѨys v@c])h7Jهic?FS.NP$ e&\Ӏ+I "'%QÕ@c![paAV.9Hd<ӮHVX*%A{Yr Aբ pxSL9":3U5U NC(p%u@;[d`4)]t#9M4W=P5*f̰lk<_X-C wT%Ժ}B% Y,] A̠&oʰŨ; \lc`|,bUvPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!R%theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK]     8@0(  B S  ? -3waXNf?Ii[t@(@0@UnknownG*Cx Times New Roman5Symbol3. *Cx Arial5. .[`)TahomaA$BCambria Math"h[5'[5'_*&**!243QHX)??I2!xx SOUTHERN UNIVERSITYsleeAnnquinette S. KingOh+'0  4 @ L Xdlt|SOUTHERN UNIVERSITYsleeNormalAnnquinette S. King2Microsoft Office Word@F#@|@/,@/,*՜.+,0 hp  susla SOUTHERN UNIVERSITY Title  !"#%&'()*+-./01236Root Entry F8,8Data 1TablerWordDocument4SummaryInformation($DocumentSummaryInformation8,CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q