Instructions

Request for Payment/Reimbursement Form

When to use this form:

To reimburse employees for miscellaneous expense
Pay service providers when no invoice is applicable
To request payment for catalog orders and subscriptions
Prepayment of conference expenses (registration fees)
Requests for honoraria and stipends
When a vendor submits statement, in lieu of an invoice (statements are not usually allowed as documentation, some vendors do not use invoices)

When NOT to use this form:

Payment requests for approved invoices (invoices with an invoice number) must be paid on the Invoice Payment Authorization Form
Reimbursements for amounts less than $30.00 should be handled through the Petty Cash fund for your department. To request Petty Cash contact Paula Langer in the Bursar's Office at x4365. A corporate purchasing card is available for small purchases such as supplies or meals. Purchasing cards can be obtained through Abby Bienkowski in the Controller's Office at x4413.
Reimbursement for travel expenses (use the Travel Reimbursement Form).

Instructions for use:

The Request for Payment/Reimbursement Form must to stapled ON TOP of the documentation that needs to accompany the form to Accounts Payable. Please staple in the upper left hand corner of the Payment/Reimbursement Form.
Please use the legal name of the person your paying. Do not use nicknames or abbreviations (i.e. Susan Hogan, not Sue Hogan).
Address is a required field and must be completed for payment to all vendors.
A completed IRS W9 form should be submitted with the form for payments to individuals for consulting, professional and fee-based (contract) services.
New vendors: (see below)
If you are paying a vendor for the first time, please indicate on the form that the vendor is new. Accounts Payable must obtain a W-9 form before payment for services can be made. When arranging for services from a new vendor please ask them to forward a copy of their W-9 form to Abby Bienkowski to Accounts Payable. If they need a form sent to them, please contact Abby by email to initiate that process.
Indicate if the vendor is an Williams employee, Williams student or Other
Indicate if the check requires special handling (i.e. if there is an enclosure or the check needs to be picked up). NOTE Checks should only be picked up in cases of extreme emergency.
Enter the complete chartfield string. If a chartfield string is not required (i.e. project) leave it blank.
Billing date: date which appears on the bill.
Amount: enter the amount including a decimal point and cents (i.e. $100.00 not $100). If you are handwriting the form make the decimal point clear.
The total dollar amount of the voucher will calculate automatically and should agree to the total on the supporting documentation.
Original receipts are required for all reimbursements. If the original receipts are not included, the reimbursement amount will be handled as a taxable payment (i.e. reported to the IRS on Form 1099).
Receipts that are not letter size must be taped to one side of an 8 1/2 x 11 white sheet of paper. Several receipts may be taped to each sheet (one side only). This process will significantly improve the review of receipts and processing of payment. Please do not overlap receipts when taping to the white sheet of paper.
Proof of payment and receipt are required for reimbursement of mail order items. (see below)
Examples of proof of payment:
Copy of the front of a canceled check
Original itemized credit card receipt
Paid receipt

Examples of proof of receipt:
Order acknowledgment
Paid receipt for goods received
When using this form to place an order or prepay a conference expense, supporting documentation such as the conference registration form must be attached.
Submit
Copy of the registration form
Membership form
Subscription
Order blank
Description of the goods and or services being purchased
Staple all supporting documentation to the back of the Request for Payment/Reimbursement Form. Place the staple in the left hand corner of the form.
Once the form is completely filled out and supporting documentation is attached the form should be signed by the preparer AND the authorizing signature(manager of account). Names should be both printed and signed.