Student Ad Hoc Payment Request Form

The Student Ad Hoc Payment Request Form is available in PDF format.

(Downloadable Instructions)

Form Instructions

Purpose

Authorize payments to students for awards and prizes (select spend category SC0443 Awards & Prizes). The following is a short list of examples:

Grant awards made to students for research projects
Door prizes awarded at student engagement events
Grant awards made to students for travel
Student awards for participation in university funded research expos
Authorize non-compensatory student stipends and student scholarship award payments under the following condition:When the stipend or scholarship cannot be processed through the Banner Student Information System

Ad Hoc Details

Contact Person: Enter the name of the person Accounts Payable should contact to answer questions regarding the payment(s). This is a required field.

Phone Number: Enter the contact person’s phone number.

Contact Person Email: Enter the contact person’s email address.

Payment Description: Enter the name of the stipend or scholarship award.

Total Amount: You do not need to enter anything in this field. The form will calculate the total amount based on the amounts entered in the payment section of the form.

Payment Type: select Check or Direct Deposit

Payment Due Date: Enter the date payment should be made, or if payments should be made in installments over a period of time leave this field blank and enter the payment schedule in the Description/Special Instructions Section.

Handling Code: Select the appropriate handling code. This instructs the cashier’s desk on how to handle check disbursements.

Payee & Payment

Payee Information: Enter the student’s Full Name, Trojan ID number (T #), and mailing address.

Payment Amount: Enter the payment amount.

Driver Worktags

Spend Category: Select the appropriate Spend Category from the dropdown menu.

Cost Center: Enter the Cost Center Worktag

* Select an additional “Driver Worktag” type as needed: you will select the type of “Driver Worktag” from the drop-down menu, then add the appropriate worktag in the line below.

Additional Worktags

You are required to enter a Fund Worktag. The NACUBO Function Worktag is pre-populated. If you need to add a Site Worktag or Assignee Worktag you may do so, by selecting the desired Worktag type from the dropdown menu next to the NACUBO Function column. Please note that the Site Worktag is reserved for the Law School, Athletics, and Housing.

Description/Special Instructions

Enter a description of the transaction and any special instructions. Please indicate the payment schedule (amount, frequency, and/or dates) for Stipend or Scholarship Awards if the payments should be spread out over a specific period of time.

Approvals Section

Requestor Signature: The person requesting the payment must sign the form.

Budgetary Head Signature: The person authorized to approve financial transactions.

Financial Aid Signature: Route to Financial Aid for approval.

ORSP Signature: Route to ORSP, ONLY if you selected a Grant Worktag.

Submission Instructions

Submit the completed form with all required signatures through the following link:
Submit Accounts Payable Documents

Please DO NOT email duplicate copies of your documents directly to Accounts Payable.

Student Ad Hoc Requests MUST be submitted with supporting documentation.