U.S. Geological Survey Manual

Attachment 6

To: Chief, Office of Financial Management (MS 270)

Through: Division Chief Contact _____________________________

From:

Subject: Request for Payment Waiver

A waiver from the electronic payment requirement is requested for the invoice and vendor shown below for the reason checked below.

• Vendor Name: __________________________________________________
• Vendor Code: ___________________________________________________
• Invoice Number: _________________________________________________
• Contact Name and Phone Number: ___________________________________

• ____The cost of using EFT for making a non-recurring payment is greater than the cost of making that payment by check. (Note: a non-recurring payment is defined as no more than one payment expected in a 12-month period to a particular payee.)

• ____ Public necessity suggests that payment by other (than EFT) methods is in the best interest of the government.

Additional Explanation (Optional) ___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
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