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Operational Cash Advance Application Business Unit: Department Name: Amount: Purpose of Advance: Date Needed: Dates of Project: Begin Date End Date Address Phone Address/Phone of Fund Custodian: Security Provided for Funds: Account/Cost Center: Account 12102, Cost Center 00730-2080-H0160-F0842-NA Requested by: Principal Investigator (if research grant) Name Signature Date Name Signature Date Name Signature Date Fund Responsibilities per MAPP 05.01.02 acknowledged by: Fund Custo.

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