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Payment request form template

Ask finance to pay a supplier, refund or advance.

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How to make a payment request form

  1. 1

    Check the questions: rename, add or delete any field, or change how it’s answered.

  2. 2

    Add your organisation’s name, a contact line and your logo if you like.

  3. 3

    Choose fillable PDF, printable PDF, Word or HTML, and the paper size.

  4. 4

    Download the payment request form and share it, print it or add it to your website.

About this payment request form

A payment request (also called a cheque or check request) asks the finance team to make a payment that doesn’t come through the usual purchase order process: a one-off supplier, a deposit, a refund to a customer, a speaker fee or an advance. It records who to pay, how much, why, and who approved it.

Attach the invoice or supporting document so finance can match the payment to it.

What’s on the payment request form

The template has 4 sections and 22 questions. Every one can be renamed, moved or deleted.

  • Requested by: Name; Department; Date; Phone
  • Payee: Pay to; Payee address; Bank name and branch; Account number; IFSC / routing / SWIFT; UPI ID (optional)
  • Payment: Amount; Currency; Due date; Purpose; Invoice or reference number; Budget or cost centre; Method (choose one: Bank transfer, UPI, Cheque, Cash); Supporting documents attached (yes or no)
  • Approval: Requester signature with date; Decision (choose one: Approved, Not approved); Approved by; Approver signature with date

Tips

  • Check the payee’s bank details by phone before paying a new account.
  • Quote the invoice number in the payment reference.
  • Use the budget code so the cost lands in the right department.

Four ways to save it

A fillable PDF has typing boxes, tick boxes and choices built in. A printable PDF gives clean boxes and writing lines for pen and paper. The Word file can be edited further, and the HTML code adds the same questions to a website. Browse more form templates, or design a completely different layout in the custom form builder.

Frequently asked questions

Is a payment request the same as an invoice?

No. An invoice comes from the supplier. A payment request is internal: your staff asking finance to pay that invoice or another amount.

Who approves payment requests?

Usually the budget holder, and above a set amount a finance manager or director as well.

Can I add my logo to the payment request form?

Yes. Add your organisation’s name, a contact line and a logo in “Form details”. The logo is placed into the file on your device and is never uploaded.

Can people fill in this payment request form on a phone?

Yes. Choose “Fillable PDF” and send the file. It opens in the Files or Drive app on Android, Files on iPhone, and any browser on a computer, where people can type their answers and save the result.

Is anything I type sent to a server?

No. The editor runs in your browser and builds the file on your device. Atifo has no server that could receive your form or the answers on it.

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