Payment Request Form

In ShopBlue, submit a payment request form for payment of goods or services received without an existing requisition or purchase order.


Download the Instructions

How to Submit a Payment Request Form

1. Click Payment Request

On the shopping page of ShopBlue, in the “Showcases” widget select “Payment Request” (Figure 1).

figure 1 of click payment request.

Figure 1

2. Enter Supplier Name

The payment request form is an external form from ShopBlue. Begin completing the form by selecting a supplier first. Enter the supplier name in the field (Figure 2).

Note: if the supplier is not in the system, enter and select “New Supplier”.

Figure 2 of enter supplier name.

Figure 2

3. Select Fulfillment Center

The correct fulfillment center will need to be selected depending on the funding source. Select “Select different fulfillment center” to edit. On the pop up screen, select the appropriate fulfillment center (Figure 3).

Note: fulfillment centers beginning with “030” are for RF funds; fulfillment centers beginning with “S” are for state.

Figure 3 of select fulfillment center.

Figure 3

4. Enter Distribution Method

Each supplier has defined distribution methods in their profile. You can manually override that distribution and customize your distribution by selecting the checkbox and entering the appropriate distribution method (Figure 4).

Figure 4 of enter distribution method.

Figure 4

5. Select Supplier Type and Remit To Address

In section 2, select “Individual or Supplier” for supplier type. The Remittance or Check Stub Information will automatically populate based on the selected supplier's default address. If the supplier has more than one remit to location, you can select override the default by selecting the appropriate address from the dropdown menu. If they do not have an address on file, you will be required to complete the address fields (Figure 5).

Figure 5 of select supplier type and remit to address.

Figure 5

6. Enter Special Distribution Requests

Any special instructions regarding payment can be requested in the Check or Payment Distribution section (Figure 6).

Figure 6 of enter special distribution requests.

Figure 6

7. Enter Description of Goods or Services

In section 4, enter a description of the goods or services, the unit price and quantity (Figure 7).

Note: if more than three lines are needed, select “Save to Cart and Add Another” from the Available Actions dropdown menu then select “Go.” This will save all other information on the form and allows you to enter more line items. 

Figure 7 enter description of goods or services.

Figure 7

8. Select Payment Type

In section 5, select the appropriate payment type from the dropdown menu (Figure 8).

Figure 8 of select payment type.

Figure 8

9. Enter Invoice Number and Date

In section 6, enter the invoice number and date in the appropriate fields (Figure 9).

Figure 9 of enter invoice number and date.

Figure 9

10. Enter Request Details and Justification

In section 7, enter the details and justification for the payment request (Figure 10).

Figure 10 of enter request details and justification.

Figure 10

11. Attach Supporting Documentation

In section 8, attach the supplier invoice or any other supporting documentation by selecting “Add Attachments.” The attachment name, size and date will appear after successfully attaching the document (Figure 11).

Figure 11 of attach supporting documentation.

Figure 11

12. Affirm Agreement

In section 9, select the affirmation that you have read and agree to the terms of the request form (Figure 12).

Figure 12 of affirm agreement.

Figure 12

13. Complete Form and Go to Cart

Upon completing the payment request form, in the “Available Actions” menu, choose “Complete Form and Go to Cart.” Then, select “Go” (Figure 13).

Figure 13 of complete form and go to cart.

Figure 13

14. Proceed to Checkout

Once the payment request form is completed, it will be added to your cart as a line item. You can then proceed to checkout (Figure 14).

Figure 14 of proceed to checkout.

Figure 14