аЯрЁБс>ўџ 8:ўџџџ7џџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџьЅС%` №Пbjbj"x"x 8(@@џџџџџџЄЖЖЖЖЖЖЖЪ    " ЪЮ&J J J J J J J J MOOOOOO$єh\‚sЖJ J J J J sЖЖJ J ˆJ J J J ЖJ ЖJ MJ J MJ J Q ЖЖ J > Р„ЙPЩ J i Mž0Юq ,оJ о оЖ АJ J J J J J J J ssJ J J J ЮJ J J J ЪЪЪD ЪЪЪ ЪЪЪЖЖЖЖЖЖџџџџ Payment Request Instructions PO Number-Enter the purchase order number, if applicable, that covers this disbursement. Final Payment- Mark this box if this is the final payment for this purchase order number. Date Due- Enter the due date of this payment. Vendor ID/Code- Enter the vendor number identifying the vendor to which this payment is issued, if known. If vendor is new, enter “NEW” in this field. Address Code- Enter the location # where the payment is to be made, if known. If it is a new location, enter “NEW” in this field. Invoice Number- Enter the invoice number, account number or any unique information that will identify this payment. Invoice Date / Service Date or Period- Enter the month, day and year (MM-DD-YR) that the invoice was prepared or the date of the service. Payee Legal Name- Enter the name of person, company or organization who is to receive the payment. Payment Handling Instructions- Indicate instructions for handling the payment. Payment will be made via direct deposit (ACH) or EFT if account information is on file. *Checks held for pick up may be picked up between the hours of 2:00pm-4:30pm Monday – Friday at 6116 N Central Expressway, suite# 205B. (If check is not picked up within 5 business days it will be mailed to payee.) 51АЕЭј ID- Enter the 8 digit 51АЕЭј identification number. Country- Enter the country for vendors outside the United States. Permanent Address- Enter the mailing address of the vendor, if address code is unknown. City- Enter the city where the payee is located, if address code is unknown. State- Enter the 2-character state abbreviation for vendors in the United States, if address code is unknown. Zip- Enter the zip-code for all U.S. and foreign vendors. Reason for Payment- Indicate the reason for payment. Purpose of Payment- Enter complete explanation to document purpose of payment. For an entertainment expense please state purpose and list dates and names of attendees. There is a separate “Entertainment Expense” form that you may utilize if necessary. Department Name- Enter name of department requesting payment. Department Contact- Enter a department contact person in case of question. Department Phone- Enter the contact person’s telephone number. Preparer’s Name- Enter the name of the individual preparing the payment request. Ext. – Enter the preparer’s telephone number. Authorized by- Obtain F.O.’s or designee’s signature. Date- Enter the date that this payment request was approved. US Tax Residency Status- Indicate the payee residency status for tax purposes. U.S. Taxpayer ID Number-Enter tax id number for foreign payees only. W-9 Form- Indicate if a W-9 is attached or on file. W-9 is required for new vendors, change of address and change of payee name. Description- Enter a description for each line of distribution here. This will appear in the GL detail so enter the description necessary for you to identify what the charge is for. This field will hold up to 30 characters. Amount – Enter the dollar amount for each line of distribution. Acct – Enter the 4 digit account number to charge for each line of distribution. Fund – Enter the 2 digit Fund ID to charge for each line of distribution. Org – Enter the 6 digit Organization code to charge for each line of distribution. Subclass – Enter the 5 digit subclass if one has been assigned. Project – Enter the 7 character project code if one has been assigned. Total Payment Amount – This field should calculate the sum of all dollar amounts entered in the amount column. Special Approvals – Obtain signatures for special circumstances. Donations – All donations must be approved by the President. Gifts to Friends of the University – Gifts must be approved by the President, Vice President, Dean or Athletic Director and reviewed by the Vice President for Business and Finance to assure appropriate tax treatment Account 82XX – A request charged to an account beginning with 82 must be approved by Asset Management Project “G” – A request assigned to a “G” project number must be approved by Grants and Contracts. Relocation expenses – Payment request made to pay for or reimburse relocation expenses must be approved by Tax and Compliance. Floral Arrangements and Sympathy Cards – Must be approved by the President, Vice President, Dean or Athletic Director. Individual Memberships – Any payment to or reimbursement of memberships and/or dues must be approved by the President, Vice President, Dean or Athletic Director. 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