Massachusetts Payment Voucher Form PDF Details

Are you searching for a convenient way to collect payment from customers in Massachusetts? Look no further than the Massachusetts Payment Voucher Form! This all-in-one document allows businesses to quickly and securely collect payments directly from their clients. With its streamlined design, straightforward instructions, and legally compliant language, this payment voucher form can help keep your business running smoothly. Read on to learn more about how the Massachusetts Payment Voucher Form is changing the game for business owners across the Bay State.

QuestionAnswer
Form NameMassachusetts Payment Voucher Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesyear 2019 mass dor payment voucher, massachusetts input, ma voucher input, ma payment voucher

Form Preview Example

PAYMENT VOUCHER INPUT FORM

Department/Organization Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Document ID

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Trans

 

Dept

 

R/Org

Number

PV Date

 

Acctg Prd

 

Budget FY

PV

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Action

(E)

 

 

Sch Pay Date

Off Liab Act

 

VENDOR'S CERTIFICATION

 

(M)

 

 

 

 

 

 

I certify that the goods were shipped or the service rendered

 

 

 

 

 

 

 

as set forth below

 

 

 

 

 

 

 

 

 

 

 

 

 

Ref Doc ID

 

 

 

 

 

------------------------------------------------

 

 

 

 

 

 

(Please Sign In Ink)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Commonwealth of Massachusetts

Office of the Comptroller

Vendor Name and Address

Document Total

Payment Ref Number

Vendor Code

Emp

Reference Order

LN QTY

Description

Unit Price

Amount

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reference Doc ID

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LN

Trans

Dept

R/Org

 

Number

 

LN

Dept

Approp

Sub

Org

S/Org

Obj

Prog

 

TY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Proj/Cl/Grc

Actv

RPTG

Fund

BS Acct

Payment Reference Number

 

Description

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MSA#

 

Line#

 

Disc

 

 

 

Dates of Services

 

Quantity

Line Amount

 

 

 

I/D

P/F

 

 

 

 

 

 

 

 

 

 

to

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TO THE COMPTROLLER OF THE COMMMONWEALTH OF MASSACHUSETTS:

I hereby certify under penalties of perjury that all laws of the Commonwealth governing disbursementsof public funds and the regulations thereof have been compLIED with and observed.

Prepared By:

 

Title:

 

Date:

 

 

 

 

 

Entered By:

 

Title:

 

Date

 

 

 

 

 

 

 

The undersigned authorized signatory approving this document certifies that this document and any attachments are accurate and complete and comply with all applicable general and special laws and regulations.

INSTRUCTIONS TO VENDORS

-Fill in shaded area

-Direct inquires to state organization

Page of

Phone #

Approved By:

 

Title:

 

Date:

 

 

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2. Once your current task is complete, take the next step – fill out all of these fields - Trans Dept, ROrg, Number, Dept, Approp, Sub, Org, SOrg Obj, Prog, ProjClGrc, Actv, RPTG Fund BS Acct Payment, Description, MSA, and Line Disc with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Writing segment 2 in ma payment voucher

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