Refunds of Receipts Form

The Refund of Receipts form is used to request a refund to the original payee associated with receipt of revenue collected by the University.

The Refund of Receipts form is used to request a refund to the original payee associated with receipt of revenue collected by the University.

Refunds are generally issued for reasons such as returned or defective merchandise; incomplete services; cancelled conferences, registrations or other events; or funds inappropriately paid to the University, in compliance with established University policies and procedures.

 Student tuition related refunds/adjustments and housing refunds are primarily handled through Student Information System and are not to be submitted using RoR forms.


  • DOWNLOAD REFUND OF RECEIPTS FORM (BOX)**TIP – Clicking the link to view the new RoR form will direct you to BOX. A preview of the form is not available due to the macros within the Excel file; however, you can access and view the form by clicking the “Download” button in the upper righthand corner of your web browser.Image of how to downlaod ROR form from website


Only one customer is paid per form. If paying more than one customer, please fill out a Refund of Receipts form for each customer.

Within the form, highlighted cells are required pieces of information. After completing each field, use the <Tab> key to move to the next field. After filling in all the required fields, the form can be printed by clicking on the “Print RoR Form” button at the bottom of the worksheet.

Before a payment can be processed, the completed form must be signed and dated by both a Department Signer and an Authorized Signer (i.e. dean/director). The signers’ names can be typed into the Printable Form tab of the form if known.

Supporting documentation to validate the refund must be attached to the RoR request; a minimum of one form is required. Supporting documentation could include a copy of the original invoice paid, an email thread indicating the need for a refund, etc.

Send completed forms to Cash Management to be processed. An electronic copy can be emailed to Cash Management at (preferred method) OR a hard copy can be sent to Cash Management, Suite 6101, 21 N. Park Street.

Upon receipt of a properly submitted Refund of Receipt form, supporting documentation, and justification, Accounting Services will process the payment according to Wisconsin Prompt Pay statute.

Questions regarding this form should be directed to Cash Management at

 Payee Information

Persistent Vendor: If refunding a vendor that receives regular refunds or is an affiliate of UW-Madison, choose the vendor from the drop-down list. If the vendor is not a persistent vendor, choose “Not a Persistent Vendor” and enter the vendor’s name in the next field.
Name: Payee/recipient’s name. (Max – 40 characters)

Note: This field will auto-fill if a persistent vendor was chosen above.

Phone: Payee/recipient’s phone number.
Email: Payee/recipient’s email.

Payee Mailing address

Mailing Address 1: Enter street number followed by apartment, suite, or unit number, if applicable. (Max – 55 characters)
Mailing Address 2: If applicable, enter PO Box or special handling instructions (i.e. Campus mail, call for pick up, or attention: XXXX). (Max – 55 characters)
City: Enter city/town name or, if international, enter city/town name followed by other principal subdivision (i.e. Province, state, county, etc.) and postal code. Note: In some countries, the postal code may precede the city/town name. (Max – 30 characters)
State: For USA addresses only – enter 2-character state abbreviation.
Postal: Enter 5- or 9-digit zip/postal code.
Country: Enter country name.

Original transaction information

Original Journal ID: Reference to the transaction (i.e. JRR, IUJ) that shows the original deposit/receipt of the funds being refunded.
Sales Tax: If sales tax was not collected as part of the original transaction, choose “No Tax Collected”. If sales tax was collected, choose the county in which sales tax was collected; a new tab will populate, Sales Tax Calculator, and can be used to help calculate the sales tax to be refunded.
Reference/Invoice Number: Enter the invoice number from the original invoice that was paid. If there is no invoice, enter another UNIQUE identifying number (i.e. Project number and the current date as MMDDYY). (Max – 30 characters)
Invoice Date: Enter the date on the original invoice. If there is no invoice, enter the date of the original deposit.

Business Purpose for Refund

Information and Justification: Provide additional information and justification for the refund request such as why money is being refunded, business purpose, who was involved, date of the event, and/or check number.
Check Memo: Enter the message that should be displayed on the memo line of the check (Max – 70 characters)


Wire Transfer: Funds transferred electronically. Funds can be sent in US Dollars or a foreign currency. See Outing Wire Form instructions for fee structure. Outgoing Wire Form and Draft Order Forms
Draft: A check ordered from Western Union. Funds are paid in a foreign currency. $5.00 service fee.
Standard Business Check: Choose option “No”. Funds will be sent in US Dollars. No service fee.

Delivery/Handling Opitons

Wire Transfer/Draft: Handling options will auto-fill if a Wire Transfer or Draft was chosen in the previous section.
Standard Business Check: If paying using a Standard Business Check, choose one of the drop-down options to determine how the check will be routed.

Submitter Information

Department Contact Name: Enter the full name of the preparer of the form.
Department Contact Phone: Enter the phone number of the preparer of the form.
Department Contact Email: Enter the email of the preparer of the form.

Funding Information

Net Refund Amount: The first funding string provided should be the same funding string the original receipt was coded to. The amount should be the original receipt less tax (i.e. Net refund). Also include: Account, Fund, Project (if applicable), and Department codes. Program code is defaulted to ‘R’ but can be changed if necessary.
State Sales Tax: If State Sales Tax was collected, enter this amount on the second line (5%). The Account (9224), Fund, Project, Department, and Program codes will automatically populate.
County/Local/Stadium Tax: If County/Local/Stadium Tax was collected, enter this amount on the third line. The Account (9220), Fund, Project, Department, and Program codes will automatically populate.