Request Form Instructions

SECTION A:  COMPLETE THE HIGHLIGHTED FIELDS BELOW.

REQUESTING AGENCY NAME

Enter the name of agency or entity submitting request for retrieval of documents.

REQUESTING AGENCY NUMBER

Enter your agency number if this request is completed by a Missouri state agency.

Leave this field blank if your entity is not a Missouri state agency.

REQUESTOR'S NAME

Enter the name of person submitting request.

REQUESTOR'S PHONE NUMBER

Enter the telephone number of person submitting request.

REQUESTOR'S EMAIL ADDRESS

Enter the email address of person submitting request.

DOCUMENT RETRIEVAL REQUEST NUMBER

Leave this field blank.

SECTION B: COMPLETE ONE LINE PER PAYMENT VOUCHER REQUESTED.

If multiple payment vouchers are listed on the form, the payment vouchers must be listed in the following order:  Payment Voucher Acceptance Date-Agency Number-Payment Voucher Document Number

PAYMENT VOUCHER ACCEPTANCE DATE

Enter the date the payment voucher was accepted in the SAM II Financial system (mm/dd/yy).

AGENCY NUMBER

Enter the 3-digit agency number of the payment voucher document number.

PAYMENT VOUCHER DOCUMENT NUMBER

Enter the 11-digit payment voucher document number.

FISCAL YEAR

Enter the 2-digit fiscal year the payment document was processed in the SAM II Financial system.

STATE RECORD CENTER BOX NUMBER

Enter the 6-digit number listed under the column labeled "CENTER USE ONLY".

SECTION C: COMPLETE THE HIGHLIGHTED FIELD WITH A BRIEF EXPLANATION STATING THE PURPOSE FOR RETRIEVAL.

SUBMISSION INSTRUCTIONS

Submit the completed Document Retrieval Request Form by clicking the [SUBMIT FORM] button located at the bottom of the form. The completed form will route to OA/Accounting for processing. A confirmation email will be sent to you.

AGENCY NOTIFICATION

If a requestor asks for payment voucher documentation that was not originally submitted by his/her agency, then OA/Accounting will notify the other agencies that a request has been received asking to view the documentation. One exception to this is that OA/Accounting does not notify agencies when a request is submitted to OA/Accounting from the Office of the State Auditor. OA/Accounting will contact the requestor listed on this form when the payment voucher documentation is available for review.