Check Intermediary Form

This form is required when the custodian of checks, releases a check to an intermediary custodian who will present a payee with a check (i.e. paying an entertainer at the time of a performance)

This form is required when the check custodian releases a check to an intermediary custodian who will present a payee with a check (i.e. paying an entertainer at the time of a performance).


Download Check Intermediary Form (pdf)

Instructions

The check custodian will complete the Payee Name and Check Number, sign,and date the form, then releasethe check to the intermediary custodian, who will immediately sign the form. The intermediary custodian will have the payee sign and date the form upon receipt of the check. The intermediary custodian will return the completed Check Intermediary Form to the check custodian, who will then return a copy of the form to Accounting Services when providing the completed Check Distribution Log.

Year End Roll Forward Adjustment Request

UW-Madison FY19 Year End Roll Forward Adjustment Request

Period 998 adjustment transactions are used to move SFS cash balances to the proper funding string for the new fiscal year operations.

A journal entry, with a JR998 journal mask, is created to record this type of transaction. This entry will be posted in early August and creates your beginning balance in WISER.

Download the 998 Department Adjustment Request FY19 (xls)


Instructions

Complete all required fields

  • Requesting Department
  • Contact name and phone #
  • Roll From Coding: Fund, Project, Department ID or Range
  • Roll To Coding: Fund, Project, Department ID
  • Special Instructions

Enter the appropriate coding string

  • 3-digit Fund
  • 7-digit Project
  • 6-digit Department ID
  • Funds can only be requested from the funds listed to a different department or project at year end:
  • Funds – 127, 128, 130, 134, 136, 140, 141, 143, 147, 151, 166, 533

Send in the form

Follow the Year End Accounting instructions.

 

 

 

 

Business Associate Agreement Form

A document to be used with a person or entity not affiliated with UW-Madison that performs or assists in performing, for or on behalf of any unit in the UW-Madison Health Care Component, business support functions/services that involve the use of Protected Health Information.

A document to be used with a person or entity not affiliated with UW-Madison that performs or assists in performing, for or on behalf of any unit in the UW-Madison Health Care Component, business support functions/services that involve the use of Protected Health Information.


A health care provider that assists in providing treatment to patients is NOT considered a Business Associate.

For more information on HIPAA and for the most current Business Associate Agreement templates, please refer to the Office of Compliance HIPAA Privacy and Security Policies & Forms page.

Payment to Individual Report

The Payment to Individual Report (PIR) is used to request all payments to individual non-employees.

Use this form to request all payments to individual non-employees.


When to use the Payment to Individual (PIR) Form

Payments to individuals are typically used for one-time non-repetitive payments to entertainers, instructors, speakers, and consultants.

The Payment to Individual form is used to request payments to individuals except salaries, employee reimbursements and payment to sub-contractors when an employee/employer relationship does not exist.

The following are acceptable uses for this form:

  • Prizes and Awards (Note: payments related to a person’s employment with the university should be made through payroll)
  • Research Subjects

You are strongly encouraged to submit a purchase requisition and use a PO for services. PIRs over $5,000 may be reviewed by Purchasing.

The following criteria must be followed:

  • Submit only one payment per PIR form.
  • UW-Madison requires that a completed and signed form W-9 or W-8BEN be on file in Disbursements for all payments.
  • Non-U.S. Source Income payments are exempt from tax withholding and reporting.  For details on what constitutes Non-U.S. Source Income payments please refer to Federal Tax Withholding under the section on Non-U.S. Source Income. A W-8BEN must be on file in Disbursements.
  • Review Non-Resident Alien Required Documents (PDF) to ensure all appropriate documents are included with PIR. (Sensitive documents will be removed after department approvals have been completed.)
  • Please complete the Non-Resident Alien Payment Worksheet (Excel) to determine withholding amount, if any, and attach a copy to the PIR.

Access PIR Form in ShopUW+

Questions regarding this form should be e-mailed to uwsaproblemsolvers@uwsa.edu


Finding the Payment to Individual Report Form in ShopUW+

  1. After you Login, Click on “Shop” on the left-hand side.
  2. Next, click on “Shopping” in the fly-out menu
  3. Click “View Favorites”. You will see all the forms you have access to in ShopUW+. If you need access to a form that is not listed please contact, uwsaproblemsolvers@uwsa.edu

Screenshot of ShopUW+ Forms

Salary Cost Transfer SFS

This form is used to change the funding source distribution of salary charges already posted to SFS. Paper forms will be phased out in early May 2011. Use the Cost Transfer Workflow Tool instead.

This form is used to change the funding source distribution of salary charges already posted to SFS.


Download Salary Cost Transfer SFS form

Paper forms will be phased out in early May 2011. Use the Cost Transfer Workflow Tool instead. The tool is a web-based form and routing system that will be used to process both non-salary and salary cost transfers.

For transfers involving sponsored projects (fund 144 or 133), there is an additional work flow approval in Research and Sponsored Programs.
Cost Transfer Workflow Tool (requires NetID Login)|