Direct Pay, Multiple Payees

This is the standard form to be used by UA Little Rock employees for the purpose of authorizing payment for non-compensatory stipends that cannot go through financial aid. Stipends paid more than once a semester cannot go through a financial aid disbursement. This form is used to indicate more than one payee. The form can be used as a cover sheet for an attached list of payees and their relevant information.

Direct Pay, Multi-Payee

TOTAL AMOUNT: Total amount to be paid.

DATE: Date of the check request.

STIPEND NAME: What the stipend is called.

CONTACT PERSON: Name of person to be called if there are any questions.

PHONE NUMBER: Phone number of the person to be called if there are any questions.

PAYEE: Full name as listed in BANNER of the people to be paid (no nicknames).

VENDOR NUMBER: BANNER ID numbers of the people being paid.

FUND: BANNER fund number (first part of the FOAPAL)

ORGN: BANNER organization number

ACCT: BANNER account number

PROG: BANNER program number

ACTY: BANNER activity number

LOCN: BANNER location number

AMOUNT: Amount to be paid on the FOAPAL for this person each time a check is cut.

DESCRIPTION AND SPECIAL INSTRUCTIONS: Special instructions for the payment of the check, disposition of the check, and any further communication to the AP accountant regarding the check. For reoccuring payments, the month’s the stipend is to be paid, and the dates of payment should be checked.

PHONE NUMBER FOR CASHIER: If the check is to be picked up, this is the phone number the cashier is to call when the check is ready.

DISPOSITION: Select either MAIL, HOLD, RETURN TO DEPT., or DIRECT DEPOSIT. Mail or nothing selected means the check will be mailed. Hold means the check will be held at the Cashier’s Office for pick-up. Return to Dept. means the check will be sent through campus mail to the requesting department. If Direct Deposit is selected, the check will be direct deposited; however, if direct deposit is requested and the recipient is not set up for direct deposit, the required paperwork will need to be attached to the direct deposit form. Otherwise, the check will be mailed.

REQUESTED BY (SIGNATURE): The name of the requester of the check.

APPROVED BY BUDGETARY HEAD (SIGNATURE): The signature of the person who has the authority to spend money out of this fund.

APPROVED BY GRANTS: Signature of grant accountant (ORSP), if required.

DATE: Date of signatures.

APPROVED BY FINANCIAL AID: Signature by Financial Aid representative, if required.