Request for Chargeback

CSUSB General Accounting Office


This form is for internal CSUSB staff use. If you have any questions, please contact Karen Prill (kprill) in the Accounting Office at 537-3644. Thank you.

All Fields Are Required


Requested by:


Date:
   
@csusb.edu

@csusb.edu

This charge back must credit the account bearing the expense for the services or materials provided. This chargeback cannot credit a Trust account for services or materials provided at the expense of the operating fund.

 

PS Credit Chartfield:




PS Debit Chartfield:




To send this information, please press the SUBMIT FORM button below. Once you have done this, information is sent immediately. If you discover an error, please contact Karen Prill in Accounting at extension 537-3644


California State University, San Bernardino
5500 University Parkway, San Bernardino, CA. 92407
Phone: 537-3644, Email: Karen Prill
Last Updated: