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U.S. Geological Survey Manual

Attachment 6

SAMPLE WAIVER REQUEST

DATE

MEMORANDUM

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.

Additional Explanation (Optional) ___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________


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U.S. Geological Survey, 807 National Center, Reston, VA 20192, USA
URL: http://www.usgs.gov/usgs-manual/im/eft-waiver-request.html
Content Information Contact: jblickley@usgs.gov
Contact: OIS, Corporate Information Technology Branch
Last modification: 11-Jan-2013@10:57 (bt)