Williams College - Controller's Office
Request for Payment/Reimbursement Form

Use this Form when:
Making payments for Honorariums, Non-Employee Stipends, Petty Cash or Personal Reimbursements.
Making payments to a vendor whose bill does NOT have an invoice number.
Payments to Williams College students and employees for services rendered should go through payroll, unless the payee is classified with the Campus Activities Office as an independent contractor.
Vendor Legal Name:

Tax ID - Contact Accounts Payable for W9 form. Required prior to payment of services, stipends, honorariums.

Address: (req'd for all Vendors)

Vendor Classification: Wms Employee
Wms Student
Other

Payment Method: Check
Direct Deposit

Special Handling: Enclosure
Pickup (Emergencies Only)

Description: (max. 30 characters) used in lieu of invoice number, will appear on check stub
PS ACCOUNT
(6)
FUND
(3)
DEPT ID
(7)
PROJ/GRNT
(6)
BILLING DATE
(mm/dd/yy)

AMOUNT
(insert a decimal)

Item Description: (max. 30 characters) will appear on financial report only
Item Description: (max. 30 characters) will appear on financial report only
Item Description: (max. 30 characters) will appear on financial report only
Item Description: (max. 30 characters) will appear on financial report only
Total U.S. Dollar Amount of Voucher:
Prepared By:
Signature:__________________________________Phone:___________Date:___________
Authorized By:
Signature: _________________________________Phone:___________Date:___________