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LifeSpring Assembly of God

951-683-6081
    
1224 Main Street
Riverside, CA  92501
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FUND REQUEST
Ministry/Department*
Department Leader*
Person Requesting*
Purpose*
Amount*
Date Needed*
Please process the payment as follows*
 MAKE PAYMENT
 REIMBURSEMENT (receipts MUST be attached)
 TRANSFER FUNDS
Make payment to
Address
City, State, Zip
What would you like us to do with the check when it is ready?
 Please mail check
 Please put in dept. box
 I will pick up check from the office
OR Transfer funds
From Account
To Account
Your email address*
FOR OFFICE USE ONLY:
Date Check Cut:
 Date Mailed:
 Date Picked Up:
 Date Put in Dept. Box:
Date Transfer Made:
 Date of Confirmation via E-Mail / Text:
 Date Confirmation Put in Dept. Box(es):
INITIALED:


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