Check Request Form 

Agent Name   Required 

Email Address 
  Required 

Request Date 
  Required 

Vendor Number 
  Required 

Invoice Number 
  Required 

Sabre Locator - If applicable please email accounting

Office Branch  Bartlesville Tulsa   Required (Select one)

Passenger Name   Required 

Pay Check to   Required 

Attention   Required 

Street Address     Required 

City   Required 

State   Required 

Zip     Required 

Gross   Required 

Commission   Required 

Net   Required 

Remarks on Check   Required 

Is check to be mailed 

 USPS     FedEx      (Overnight required?) - (Make Selection) 

If FedEx - Vendor phone # (not 800) 

Date due to vendor   Required 

  Please enter a valid email address   Required