Application for Online Recharge Service Number

Please fill out a separate applications for each service.
The service number will allow you access to the Recharge Billing System.

Department code: ______	Department name:
Department contact(s):
Telephone extension:		Logon ID(s):

The above information should pertain to the people responsible for the on-line recharge input.

Is this an approved recharge activity? Yes_____ No ____

The approximate number of recharges done monthly. _______

For what service will you be recharging?

What object code will be debited? _________

Recharge description ( up to 20 characters). ________________________________
This will appear in the "description field" on the FSO100 general ledger - Example: Acctng Off/Fax Srv

List up to five full accounting units (FAU) that will be credited for the recharge activity. Put the FAUs in order of the most frequently used first. The system allows for five preset FAUs, additional FAUs can be input manually in as needed.

	Loc	Account/	CC-	Fund	Project code	Sub	Object code
1.	4					09	3900
2.	4					09	3900
3.	4					09	3900
4.	4					09	3900
5.	4					09	3900

Signature:	Date:
Title:

FAX the completed form to: Terri Kirkman General Accounting X 48792