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Custodian Fund Agreement Form

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Use this form to request custodian funds for human subject studies, change funds, petty cash and contingent bank accounts. All Custodian Agreement must be completed by the Custodian and approved by the Department and Dean's Office before the advance is sent onto Cash Management for processing. All agreements must have a Custodian Fund Request Form and Custodian Fund Budget Information Form attached with this agreement.

Use this form to request custodian funds for human subject studies, change funds, petty cash, and contingent bank account.

Download the Custodian Fund Agreement Form (PDF)

Instructions

Custodian Funds are advanced only to authorized, permanent UW–Madison employees. The Custodian Funds are issued for a specific purpose and may not be used for any other purpose than expressed on the Custodian Fund Request Form.

All Custodian Funds must be reconciled monthly to authorized advance levels and properly accounted for within 30 days of the end of the advance period.

All Custodian Funds require, quarterly reporting, regardless of activity, to ensure advance levees are maintained by using the Custodian Fund Accounting Form.

Top paragraph: Fill in the dollar amount of the Custodian Fund and enter the same amount in the Custodian Fund Request Form. Enter begin and end dates of the Custodian Fund Request. Enter the Custodian Fund reference number which agrees with the Custodian Fund Request Form.

Individual Custodian Agreement paragraph: Enter the custodian name and ensure it agrees with the Custodian Fund Request Form. Include in this section, the Custodian telephone number, and the Custodian e-mail. The Custodian must sign and date this Custodian Fund Agreement before it can be reviewed for approval and processed.

Department Agreement paragraph: Filled in the Department name.

Bottom section of this agreement:

  • Print Name (Department Representative): Filled in with the name of the department representative.
  • Telephone Number (Department Representative): Fill in with the telephone number of the department representative.
  • Email (Department Representative): Fill in with the email address of the department representative.
  • Signed (Department Representative): This section must be signed and dated by the department representative.
  • Signed (Dean/Director): This section must be signed and dated by the Dean/Director.

Custodian/Department

Keep a copy of the Custodian Fund Agreement along with the Custodian Fund Request Form and Custodian Fund Budget Form for internal records.

Dean/Director’s Office

Keep a copy of the Custodian Fund Agreement along with the Custodian Fund Request Form and Custodian Fund Budget Form for internal records. Email documents to cstdnfnd@bussvc.wisc.edu or send to Cash Management, 21 N. Park St., Suite 5270, Madison, WI 53715.

Related policies and procedures

UW-3012 Custodian Funds Policy

Contact

Questions can be directed to cstdnfnd@bussvc.wisc.edu.

Custodian Fund Request Form

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This form is used to request custodian funds for Human Subjects Studies, Change Fund and Petty Cash.

A form used to request custodian funds for Human Subjects Studies, Change Fund, and Petty Cash.

Custodian Fund Request Form (PDF)

How to complete the Custodian Fund Request Form

  1. Provide details about the requested fund. Based on your budget form, enter a positive amount for the total of the request. Enter the Workday FDM values you want these expenditures to be charged to.
  2. Enter unique 7-digit Custodian Fund ID from original Custodian Fund Request Form. All custodian funds will start with NR, followed by the unique 7-digit Custodian Fund ID.
  3. Put an “X” in the “Type of Custodian Fund Request” section (i.e. Research Participant Study, Petty Cash, Change Fund, or Reloadable Debit Cards – Research Participant Study).
  4. Ensure that the IRB number is entered into the “IRB Approval No” box.
  5. Fill in the Start Date and End Date of the study under the “Time Period” section.
    • For Temporary Request mark “X” 3 months or less.
    • For Reloadable Debit Card Account mark “X” 1 year or greater.
  6. Fill in the custodian name and check payable information. Check payable will most likely be the custodian of the study. Fill in the building name, address, city, and state underneath the custodian name and check payable lines.
  7. Leave the “If address is different[…]” boxes empty unless the check’s intended delegate or address is different than the custodian address.
  8. Complete the “For additional information call” section with the contact name and phone number.
  9. Under the “Description/Amount Requested” section, provide a description of how the advance will be used. Fill in the Research Participant Study title, IRB Approval No., IRB Begin Date, IRB End Date, and provide a description of the project. If the operation is a Petty Cash Fund, provide a description of the operation under the respective section. If the operation is a Change Fund, provide a description of the operation under the respective section. Include the amount of requested advance for each operation needed.
  10. Confirm/enter the total amount of advance(s) from all requested operations in the “Total Amount Requested” section.
  11. Form is signed by the custodian. A delegate signature is also required if the check is not payable to the custodian.

Department/Unit

  1. Verify information on Steps 1-11.
  2. Department approver signs custodian fund accounting form.
  3. File original documents in department.
  4. Send copy(s) to the Dean’s/Division Office for approval.

Custodian/Department

Keep a copy of the Custodian Fund Agreement along with the Custodian Fund Request Form and Custodian Fund Budget Form for internal records.

Dean/Director’s Office

Keep a copy of Custodian Fund Agreement Form along with the Custodian Fund Request Form for internal records. Send original documents to Cash Management, 21 N. Park Street, Suite 5270.

Policy & Procedure

UW Policy 3012 – Custodian Fund Policy

Contact

Questions about this form can be sent to cstdnfnd@bussvc.wisc.edu.

Department Purchasing Card Pre-Authorization Form

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Department Purchasing Card Pre-Authorization Form - Purchasing Card related

Approval is required before you can borrow a Department Purchasing Card from a Department Card Administrator to make authorized purchases. You can request approval using the Department Card Pre-Authorization Form.

Submit this form no more than five (5) days prior for a purchase request with a Department Card.

Reminder: Department Card usage is only for business-related, low-dollar, occasional purchases from local or online vendors. See Procedure 3013.7 for more details.

A new online approval process (through Kuali Build) launched June 16, 2026 for Department Purchasing Card Pre-Authorization.

Log in with your NetID and complete the information in the form. Your submitted request is sent to your supervisor for purchase approval. After supervisor approval, the Department Card Administrator (DCA) has a final approval step based on appropriateness of using the Department Card for the requested purchase.

Access Department Purchasing Card Pre-Authorization Form (Kuali)

Questions or issues with this form can be reported to Meghann Grove.

DWD Order Form

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DWD Order Form

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Contact Information

Name*

Order Details

Ship To Address*
*
Item Number
Order Qty
 

Educational Outreach Payment Form

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Use this form to submit a payment to the Bursar's Office for posting to a student's account in the Student Information System (SIS).

This form is specific to Education Outreach and Partnerships (EOP).

Use this form to submit a payment to the Bursar’s Office for posting to a student’s account in the Student Information System (SIS).

This form is specific to Education Outreach and Partnerships (EOP).

Download the Education Outreach and Partnerships (EOP) Payment Transfer form (xlsx)

Instructions

  1. On the form, select the transaction type: Outreach Credit Card or Outreach Payment. A separate form for each type of transaction is required.
  2. Enter Term Code.
  3. Complete Campus ID, Name and Amount.
  4. Save the form to a folder on your computer. You may assign any file name desired.
  5. Upload the form to the Bursar’s Office Secure Website.

 

Entertainment Contract

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Use the Entertainment Contract for the personal services of a performer(s) stating the arrangements and compensation for entertainment services provided at an event open to the public.

Use the Entertainment Contract for the personal services of a performer(s) stating the arrangements and compensation for entertainment services provided at an event open to the public.

The contract is entered into between the University of Wisconsin-Madison, hereinafter called the “University”, and the undersigned performer(s), hereinafter called the “Artist”, even if there may be more than one person, for the personal services of the Artist.

Download Entertainment Contract (doc)

Related Policies and Procedures

Evening MBA Cohort Charges Form

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Use this form to submit Evening MBA Cohort Charges to the Bursar's Office for posting to a student's account in the Student Information System (SIS).

Use this form to submit Evening MBA Cohort Charges to the Bursar’s Office for posting to a student’s account in the Student Information System (SIS).

Download the Evening MBA Cohort Charges Form (Excel)

Instructions

  1. On the form, enter the Term Code.
  2. Complete Campus ID, Name, Tuition Amount, Program Fee, and Technology Fee.
  3. Save the form to a folder on your computer. You may assign any file name desired.
  4. Upload the form to the Bursar’s Office Secure Website.

Evening MBA Enrollment Deposit Form

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Use this form to submit an enrollment deposit or forfeiture to the Bursar's Office for posting to a student's account in the Student Information System (SIS).

This form is specific to the Evening MBA.

Use this form to submit an enrollment deposit or forfeiture to the Bursar’s Office for posting to a student’s account in the Student Information System (SIS).

This form is specific to the Evening MBA program.

Download the Evening MBA Deposit Form (Excel)

Instructions

  1. On the form, select the transaction type: Deposit or Forfeiture of Deposit. A separate form for each type of transaction is required.
  2. Enter Term Code.
  3. Complete Campus ID, Name, and Amount.
  4. Save the form to a folder on your computer. You may assign any file name desired.
  5. Upload the form to the Bursar’s Office Secure Website.

Events – Participant List

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Formatted participant list for use with event forms or payment/reimbursment mechanism for meals, refreshments, reception costs where a list of participants is required for payment.

Formatted participant list for use with event forms or payment/reimbursement mechanism for meals, refreshments, reception costs where a list of participants is required for payment.

Download Events – Participant List Form