Miscellaneous AR Department Billing Source Add/Update

Department Name(Required)

As it will appear on invoices

Billing Source Code(Required)

For modification requests, please enter your Billing Source Code below. If this is a new request, please select NEW.

NEW

Other

Billing Inquiry Phone Number(Required)

As it will appear on invoices

Primary Billing Type(Required)

Goods

Services

Billing Method(Required)

I will generate invoices from another system

I will enter invoices manually

Primary Billing Specialist

The primary person who will create invoices, request customer setup or modification, report on or look up billing and payment activity (one per department/source)

Billing Specialist Name(Required)

First Last

Billing Specialist Emplid(Required)

Billing Specialist Phone(Required)

Billing Specialist Email(Required)

Billing Authority

The management level person ultimately responsible for billing activity for this department

Billing Authority Name(Required)

First Last

Billing Authority Emplid(Required)

Billing Authority Phone(Required)

Billing Authority Email(Required)

Others Who Will Need Access

Please list all others who will need access for requesting customer records, bill entry, printing, or reporting.

Name

Emplid

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