Request Date________________
PLEASE ISSUE A CHECK FOR THE FOLLOWING:
Pay to the Order of:________________________________________________
Mail to:____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
Description:_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
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TOTAL AMOUNT PAYABLE $________
Requested By:__________________________
Return Form by mail:
Ted Baldwin
Library, MSN 38
Equistar Chemicals, LP
11530 Northlake Drive
Cincinnati, OH 45249
Email questions to Kevin:ted.baldwin@UC.Edu