Form Instructions

Procedures for completing a Check Request Form:

1. Enter the date and fill in the vendor’s name and address, or the name of the person being reimbursed and his/her address in the spaces provide

2. In the explanation section, describe the items purchased (e.g., pencils, stationery). If you are requesting an advance, write the word “ADVANCE” in the explanation section and attach an Advance Request form.

3. In the section noted UR/R, enter 01 to denote the use of unrestricted dollars, and 02 to denote the use of restricted dollars.

4. The Line Item section should indicate the expense code, which states the type of expense made.  This could be food, salaries, travel, supplies, etc. (e.g. 5120 is Food).

5. The Fund section will reflect the department code that needs to be charged.

6. Once the form is complete, the program manager should sign and date the form, then give it to the department head to sign and date, followed by the Vice Chancellor/Direct Report in charge of the program.

7. Once all the signatures have been acquired, the form should be given to Rose Ellerbe, Accounting Manager for the Foundation.

8. You must submit the completed request to the Foundation Office by the Friday of the week prior to the week you wish to pick up your check.  Checks are released each Wednesday.  At all other times, the checks will be secured.  You may have someone else pick up your check for you.  Anyone picking up checks will be asked to sign for them.

Supporting Documents for Check Requests Forms:

• Request for Reimbursement-- Attach the original receipts to the Check Request Form.  If using a charge card this refers to the detail receipt not the summary charge receipt.  If this is reimbursement for a meal please list those in attendance.
• Advance-- A Foundation Advance Request Form must be filled out and signed by the individual, program coordinator, Direct Report, and Executive Director of the Foundation.  Attach this to the Check Request Form.  When the expenses have been incurred, submit the Receipts and Reimbursement of Unspent Funds or Request for Reimbursement.  
• Payment of an invoice-- Attach the original invoice to the completed Check Request Form.  Please sign and date the invoice and the check request.

Lost or Stolen Checks:  If your check is lost or stolen please complete an affidavit and turn in the completed notarized form to the Foundation Accounting Office. 

Procedures for completing an Affidavit and Indemnity Bond Form:

1. The affidavit and indemnity bond form should be completed when a Foundation check to an affiant is in question.  This could be when a check has not been received that should have been, when a check has been stolen, lost, or accidentally destroyed, or when the check amount is not correct.

2. Please fill out this form in the presence of a notary.

3. Please indicate the state and county in which the affidavit is being filled out.

4. Please indicate who is filing the affidavit, along with the check information in question and the cause for concern regarding the check.

5. The affiant will then need to sign and date the affidavit in the presence of a notary and obtain the notary seal and signature.

Procedures for completing a Foundation Travel Authorization and Reimbursement Request Form:

You must complete items 1 through 14 properly and have the form in the Foundation Office at least two (2) weeks prior to date of travel.

Enter Date: Date T/A typed

1. Enter traveler's department name.

2. Enter account number or account name.

3. Enter Travel Coordinator's name (this is the person filling out the form)

4. Enter extension number of Travel Coordinator.

5. Enter estimated cost of meals, lodging, mileage, transportation, registration, and other expenses.

6. Do not enter (for Foundation Office use only).

7. Enter excessive amounts for lodging, registration. (No excessive meal allowance).

8. Traveler's name and title.

9. Registration (If Foundation Office is to mail the registration, please send original Registration Form and once copy with T/A form).

10. Advance Requested. (Foundation Office will issue advanced check if completed form is received two weeks prior to travel).

11. Dates of travel (departure and return).

12. Destination (enter city and state).

13. Name of function.

14. Special Instructions (includes limited funds, advanced air fair, shared rooms, etc).

Signatures Required: Traveler, Program Director/Principal Investigator, Vice Chancellor/Direct Report, and President of the Foundation

T/A is forwarded to Foundation Office for processing Registration (attach completed Registration Form) and Advance requested.

Complete items 15 through 25 and return the form to the Foundation Office with supporting documentation within five (5) working days after return from travel or cancelation of travel.

15. Enter date(s) of travel, departure, and arrival time(s)

16. Travel from: enter city and state of departure.

17. Travel to: enter city and state of destination.

18. (1) Type of Transportation: C = Car    A = Air    R = Rail    O = Other

19. Daily Private car mileage.

20. Transportation costs; TOTAL COLUMN.

21. Subsistence (2) Type:  B = Breakfast    L = Lunch    D = Dinner    H = Lodging

22. Daily totals of meals and lodging; TOTAL COLUMN.

23. Explanation of Other Expenses (registration, taxi, limo, tips, parking, etc.)

24. Amount of each (other Expenses); TOTAL COLUMN.

(a) Pick up TOTAL from columns 19, 22, 24.

(b) Total advance (money advanced by Foundation for registration, airfare, etc).

(c) Amount due to NCSSM Foundation (if Advance exceeds Total Expense) - enter difference and return a check made payable to NCSSM Foundation for the difference, along with a completed T/A to Foundation office.

(d) Amount Due to Traveler (if Expenses exceed Total Advance) - enter difference and the Foundation will send a check for the difference to the Traveler.

26. For Foundation Office use only

Signatures Required: Traveler, Program Director/Principal Investigator, Vice Chancellor/Direct Report, and President of the Foundation

All correspondence regarding the trip, advances, or reimbursement checks will be sent to the Travel Coordinator.

Procedures for completing a Check Request Form:

1. Please indicate the NCSSM contact person and extension number.

2. Please fill out all information regarding the personal or real property being donated, including the description, age, and any possible maintenance that may need to be done.

3. Please include the donor information, reason for giving, and what designation the owner wishes to have for the property.

4. Please indicate whether or not the property has been evaluated and by whom, how the property will be acquired by the Foundation, and an estimation on the value of the property.

5. Please note the donor will be thanked for the gift. The donor is responsible for the valuation, not the Foundation or the school.