%PDF-1.7 University of Arkansas Admissions; Academics; Campus Life; … Travel Authorization Form (PDF)- Please complete and submit this form before travel begins. Overview. Request for Disposal of Surplus Property- Please complete and turn in at the main office in SCEN 601. Complete the employee section (pages 3 and 4) of the University of Arkansas Long-term Disability Conversion Insurance form. ANTH Personnel Form. Department of Biomedical Engineering John A. Any financial aid received in the form of a paper check with the student listed as a payee requires an endorsement after it is in the possession of the University Cashiers Office (ARKU 214) before it can be disbursed. White, Jr. Engineering Hall 790 W. Dickson St. Suite 120 Fayetteville, AR 72701 Phone: 479-575-4667 Fax: 479-575-5619 Your one stop for managing your student health insurance plan. This form should be signed by the person claiming reimbursement. stream 2. To use this form you must first login to RazorBuy. On the Home/Shop screen of RazorBuy, click forms located under the search bar. Fulbright College Writing Requirement Form, Override/Administrative Change of Registration Form. Human Resources 222 Administration Building Fayetteville, AR 72701 479-575-5351 Fax: 479-575-6971 Visit the university's main page about quarantine and isolation procedures for the latest information.. REIMBURSEMENT CLAIM FORM DEPARTMENT:_____ DATE: _____ PAY TO: _____ (Must normally be a Universi ty employee. <>/Metadata 142 0 R/ViewerPreferences 143 0 R>> Claim forms without the required information cannot be processed and will be returned to sender. Do not submit cancelled checks or credit card receipts alone. TOTAL: (May not … You will also receive a system generated email regarding your payment once it has been processed. Online. Personal Reimbursement Claim Form. endobj Access Workday through the Workday App Located at myapps.microsoft.com and login with your university credentials. ; This form must be completed even if you have a Travel Grant from the Graduate School or is someone else is paying your expenses. A new Travel Claim process in BASIS is replacing the paper form, ‘Statement of Traveling Expenses’. Official Function Form. E. EstimatedMeetingExpenses: Notes: … Contact Phone No. Fayetteville, Arkansas 72701479-575-4801 Procurement Card Report. Subscriber Information (Please print clearly) Subscriber Name Daytime Phone ( ) Evening Phone ( ) Mailing Address City State Zip Subscriber ID Number Name of Employer . Click the Employee Reimbursement folder from the side menu. The University of Arkansas has partnered with BankMobile, a division of Customers Bank, to deliver financial aid and other school … The University extends the employment benefit of a tuition waiver as established through Board Policy 440.1.The administration of this employee benefit at the Fayetteville campus is defined in Fayetteville Policies and Procedures 512.0.The Employee Tuition Waiver Chart provides a Definition of Terms regarding eligibility and details regarding waivers for Employees and … REIMBURSEMENT CLAIM FORM - MOVING EXPENSES BU PAYEE TIN NUMBER DATE OF MOVE PO NUMBER AP ID CCI CCC SPECIAL NOTES: QUALIFIED EXPENSE NON-QUALIFIED EXPENSE (NON-TAXABLE) (TAXABLE) EXPENSE TYPE BOX 13 OF W-2 BOX 1 OF W-2 Actual Cost of Move Transportation (one-way) Hotel * Meals (always Non-Qualified) House Hunting (always Non-Qualified) Family Move … COST. tcdocs@uark.edu is the email address to send Admin TCard documentation ONLY ... Any time a membership is purchased in conjunction with a conference registration, this form must be attached with the other claim documentation. Wire Transfer Form . 324 Graduate Education Building University of Arkansas Fayetteville, Arkansas 72701 +1-479-575-3208; coehp@uark.edu Once final approval has been granted for monetary reimbursement for an employee-owned device, the Cellular Communication Justification and Approval form must be forwarded to the accounts payable office. Graduate Student Employee Application-Please complete and turn in at the main office in SCEN 601. EMPLOYEE REIMBURSEMENT CLAIM FORM. praborn@uark.edu. (Open using Internet Explorer browser). Official Function Form . Personal Reimbursement Form - Include the Workday Worktag in the appropriate field or the reimbursement will not be processed. Accounts payable will develop a database of the approved reimbursements that will include the employee name, employee title, budgetary unit, company cost center, departmental category, the term … <> Parent Plus Loans (PPL) A Master Promissory Note (MPN) is required before funds can be disbursed. Industrial engineers are often called “big picture” engineers, because they look at systems as a whole and come up with ways to improve them. Personnel Forms. TOTAL: (May not exceed $5000.00 without special authorization) I hereby certify that the items described herein were purchased for the University of … To see the process of how an employee may request this reimbursement, go to How to Process a Request for Cell Phone Reimbursement. Affidavit for lost/stolen check. <>/XObject<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 756 576] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Health Care Reimbursement Dependent Care Reimbursement INTRODUCTION A Flexible Benefit Plan reduces your taxes and could enhance your benefits package. 750976 SI 2047 3 of 7 (5/19) University of Arkansas at Fayetteville Disability Insurance Claim Form Fraud Notices Standard Insurance Company 888.641.7194 Tel 800.378.6053 Fax PO Box 2800 Portland OR 97208 Some states require us to provide the following information to you: ALABAMA, MARYLAND AND RHODE ISLAND RESIDENTS Any … Per the University of Arkansas Cellular Communication Policy, if you are eligible to receive a cell phone reimbursement on a monthly basis, you will do so by requesting a Personal Reimbursement via webBASIS.Below is a Step by Step Guide for requesting a recurring monthly reimbursement. 1 University of Arkansas Fayetteville, AR 72701 Phone: (479) 575-2352 Fax: (479) 575-2846 . Monthly Time Sheet for Non-Exempt Employees. Educational Technology. Request for Change of Program Form (This fom is no longer in use. Careers are AgLaw, Law, Graduate and Undergraduate. College of Education and Health Professions. Reimbursement forms should be turned in to Caitlin Gragg - acgragg@uark.edu; Requisition Form; Membership Justification Form; Payroll Hourly Employee Application-Please complete and turn in at the main office in SCEN 601. A. ADDRESS FOR PAYMENT CHECK: _____ FOR: Reimbursement for emergency expenditure(s) as follows: DATE PURCHASED ITEM DESCRIPTION COST TOTAL: (May not exceed $200.00 without special … Employee Reimbursement Form; Sole Source Justification Form; Additional Forms; Travel Forms Forms to be completed PRIOR to travel: Travel Authorization form – to be completed and turned into department rep prior to travel. To assist programs with the payment process, each unit is asked to utilize the following guidelines in their planning: In preparation for the visit, please email the Director of Curriculum Review and Program Assessment the contact information for the college representative that will be processing the costs related to the visit. Financial Aid Disbursement Spring 2021. Surplus Request Form - Inventory Accounting and Finance. <> complete the employee reimbursement form be sure to enter the full amount being reimbursed (including tax) into the price do not mark the cart as taxable. Reimbursement forms should be turned in to Caitlin Gragg - acgragg@uark.edu; Requisition Form; Membership Justification Form; Payroll To establish a new imprest fund, submit a completed Request for Imprest Fund form to the Financial Affairs Compliance Office that includes the following information: Justification for intended use of the fund; Justification for the amount of money requested ; Dean or department head approval; All requests approved by the Financial Affairs Compliance Office will be then forwarded to the Chief Fiscal Officer … Personal Reimbursement Form - Complete and submit with receipts and Meals and Entertainment Justification Form if applicable. Graduate Student Forms. Travel Claim Worksheet (Excel)- Please complete and submit this form and expense receipts upon completion of travel. Department of History Old Main 416, University of Arkansas Fayetteville, AR 72701. At the University of Arkansas, we value our employees and recognize them as our organization’s greatest asset. The following information should be provided with this form: 1) Explanation of circumstances why a purchase order was not used. Personal Reimbursement Form - Include the Workday Worktag in the appropriate field or the reimbursement will not be processed. Contact HR at 479-575-5351 or hrbenf@uark.edu to request the form to convert your long-term disability insurance. Department of Biological & Agricultural Engineering 203 Engineering Hall 1 University of Arkansas Fayetteville, AR 72701 Phone: (479) 575-2352 See Personal Reimbursement Procedures for additional information.) Do not submit balance forward statements. Reimbursement for Meals that fall under the Official Function Policy (Not on Travel Status): This is in reference to meals being reimbursed primarily through the Purchasing Office unless you are an employee who has a Traveler TCard through the Travel Office. Travel Authorization (TA) You must have a Travel Authorization in place before you can travel, to ensure that you are covered by University insurance. 4 0 obj Legal Review Form. Membership Justification Form. When asking for reimbursement for meals that fall under the Official Function Policy of the U of A, an itemized meal receipt is always required. Departmental Forms. Include actual dates of service on the claim form. Per the University of Arkansas Cellular Communication Policy, if you are eligible to receive a cell phone reimbursement on a monthly basis, you will do so by requesting a Personal Reimbursement via webBASIS.Below is a Step by Step Guide for requesting a recurring monthly reimbursement. White, Jr. Engineering Hall 790 W. Dickson St. Suite 120 Fayetteville, AR 72701 Phone: 479-575-4667 Fax: 479-575-5619 Per the University of Arkansas Cellular Communication Policy, appointed employees who are eligible, may request a cell phone reimbursement. Patient … Visit. Phone: 479-575-3806 FAX: 479-575-7790 finaid@uark.edu. 2. Travel Authorization Form (PDF)- Please complete and submit this form before travel begins. (Note: May provide list as an attachment.) UNIVERSITY OF ARKANSAS NON-EMPLOYEE REIMBURSEMENT CLAIM FORM. Federal Per Diem Rates; International Travel – Student request form– use this form to register travel through Office of Study Abroad for any … R.N. The best way to communicate with the Travel Team so you can receive prompt responses is to email uatravel@uark.edu.All members of the Travel Services team monitor the uatravel@uark.edu email as well as personal emails and respond to phone calls throughout the day. What items cannot be paid on a personal reimbursement? COVID-19 Travel Form; GENERAL UNIVERSITY RELATED UPDATES ON CORONAVIRUS (COVID-19) University Travel Restrictions; Workday Information. Personal Reimbursement Form - Complete and submit with receipts and Meals and Entertainment Justification Form if applicable. Direct Deposit Authorization Form. Surplus Request Form - Inventory Accounting and Finance. Senior Exit Interview Survey; Masters Forms. Begin New Flexible Benefit Plan (requires- New eligibility or Qualified change) Flexible Benefit Plan Enrollment Form (PDF) Request … Travel Services. COST . ♦ … Reimbursement Request Phone: 479-575-2551 Fax: 479-575-4158 4help@uark.edu Off-Campus Property … University of Arkansas 321 Administration Building Campus Mail Stop: ADMN 321 Fayetteville, Arkansas 72701; P 479-575-2551; uatravel@uark.edu; UNIVERSITY OF ARKANSAS. If a student is changing from a degree in one program into another degree program, they must submit a new admissions form. Fulbright College Substitution and Exception Request Form, Out of Career Registration Instructions and Form, https://graduate-and-international.uark.edu/graduate/current-students/forms.php, Meals and Entertainment Justification Form, R25Live Calendar Access for room reservations. Even though the Travel Claim is entered and submitted via TARGET for approval, a printed Travel Claim will need to be signed by the traveler. DEPARTMENT: DATE: PAY TO: ADDRESS FOR . P 479-575-3001 F 479-575-2775 E-mail: mmadams@uark.edu Fill out all required fields (in bold) and all relevant information. Apply. Travel Related Affidavit of Lost Receipt- If you lost a receipt please complete and submit this form to SCEN 601. Anthony Travel: When using a University TCard, use of our Travel … Beginning spring 2021, payments of all types will no longer be accepted in-person at the Treasurer's Office. By allowing you to pay for certain benefits such as: ♦ Employee contributions toward health insurance premiums. Follow Us on Facebook . The Health Insurance Claim Form (CMS 1500) HIPAA and Electronic Data Interchange (EDI) Review and practice coding Evaluation and Management (E&M) services; Review and practice coding from anesthesia, surgery, radiology, medicine, and the pathology/laboratory sections of the CPT CPT Modifiers, E and V Codes and Late Effects; Coding surgical and medical procedures for the cardiovascular, … This includes Memberships purchased through personal funds, TCards or TRPOs. The Travel Office strives to provide the highest level of customer service to the campus community. If you have a positive test result, you will be reassigned to a temporary room where you can isolate until you have been released by your medical provider or the Arkansas Department of Health. ♦ Amounts for medical expenses that are not covered by your other insurance (such as deductibles or co-payments). See the application … Please submit override form from your uark student email account. An accounts receivable cost center number will be assigned to each new agent. Once the traveler has returned from their trip, they need to organize all of their required receipts so they can obtain reimbursement for authorized expenses. DEPARTMENT: DATE: PAY TO: VERIFICATION OF ADDRESS FOR PAYMENT: FOR: Reimbursement for emergency expenditure(s) as follows: DATE PURCHASED. Once this accounts … These are not adequate documentation without supporting itemization. Part 1: Member Information (to be completed by the member) 1. Submit claims within the filing … (excluding co-pay) PharmaCare Pharmacy Claim Form (PDF) Flexible Benefit Plan. White, Jr. Engineering Hall 790 W. Dickson St. Suite 120 Fayetteville, AR 72701 Phone: 479-575-4667 Fax: 479-575-5619 Then click on the form name or View Form, this will open the form in a new window. career. Form W-9S Request for Student's TIN. Travel Guide: Things to know when traveling for the University of Arkansas. Use this form for reimbursement of services received from an out-of-network provider, or when you have utilized an in-store sale or promotion from an in-network provider. QualChoice Medical Services Claim Form (PDF) Submit Prescription Drug Claim form for prescriptions paid for in full. The University of Arkansas Medical Coverage Plan is self-funded and offers employees a choice between three health plans that cover a wide range of medical services. Katherine E. Murray, Assistant Director of Benefits kem051@uark.edu. Teacher Education. Employee Resources Emergency Contact Form - Please complete a new form if anything with your contact information changes. If you are not employed by the University, please email wechever@uark.edu. Street Address City State ZIP CAMPUS of Employee (PLease CheCk One) ASMSA UAM CES UAMS UAF UAPB UACCB WRI UALR PCCUA Other: Section II. ADMN 321 1 University of Arkansas Fayetteville, AR 72701. ; A Student Code of Conduct While Traveling form … Office of Financial Aid 114 Silas Hunt Hall 1 University of Arkansas Fayetteville, AR 72701. The IRS allows reimbursement for services when the care is provided, which may not be the actual date that the patient pays or is formally billed for the charges. 1 0 obj Patient Information. career. Contact Us; Customer Satisfaction Survey; Additional Links; Financial Affairs ; Financial Aid; Registrar's Office; University Housing; Razorbuck$ Site Last Updated 1/11/2021 8:23:31 AM. If you need alternatives (written) documents or forms, contact Business Services at (479) 575-2551 or 4help@uark.edu. College of Education and Health Professions. ��DA�Z||Z%���idQ>l��&RM����vxg���#�iz��259���4.wx�V{�n���%�X�ѯ6��쾼��_.7�����/���Oӻ�a�����>n���r�)W��X�b��6u��!$� .�������W5Tp�[_����x�L���)9S���a?�Lq��J,p��%b��_ �ف_J��>���L{s�m��K*�b?�H`�O�>h]���. (If you have an … IRS Form 1098-T (Tuition Payment Statement) No reimbursement will be allowed to any traveler for personal entertainment, clothing, valet services (unless that is the only parking available at the hotel), flowers, alcoholic beverages, personal telephone calls, traveler's check service charges, laundry or cleaning, printing items, or any other items not considered to be official business expenses unless specifically authorized by the Travel Office and … View benefits, enroll, waive, or contact Customer Care. As of Fall 2020, we are implementing an acceptance deadline for all employee and spouse/dependent waivers. The Eleanor Mann School of Nursing's program Registered Nurse to Bachelor of Science in Nursing (R.N.-B.S.N.) T Card Forms (Interactive PDF) T Card Employee Agreement Form; T Card Lost/Unobtainable Receipt Form; T Card Delegation Form ; T-Card Dispute Form . They help people accomplish tasks safely, quickly and … Evaluation of Graduate Student Progress for Biology Graduate Students, Additional graduate student forms can be found at https://graduate-and-international.uark.edu/graduate/current-students/forms.php. 2 0 obj Personal Reimbursement Form - Complete and submit with receipts and Meals and Entertainment Justification Form if applicable. Documents must support claim that student may not be afforded the opportunity to attend the University of Arkansas because of extreme financial strain caused by the expense of living on campus, and that cost of living off campus is significantly less expensive than living on campus. Mileage Log Worksheet University of Arkansas 321 Administration Building Campus Mail Stop: ADMN 321 Fayetteville, Arkansas 72701; P 479-575-2551; uatravel@uark.edu Find Workday Support Services, including Training, on the UA … Out of Career; Graduate Credit for 3000-4000 Level Courses; Undergraduate Forms. 1. Complete the non-employee … 1 University of Arkansas Fayetteville, AR 72701 Phone: 479-575-5451 Fax: 479-575-4651 Email: registra@uark.edu. Fulbright College of Arts & Sciences COST TOTAL: I hereby certify tha t the items described herein were purchased for the University of Arkansas and were paid for from persona l funds. Treasurer's Office, located in the Arkansas Union, Room 214 from 8:00 am to 5:00 pm Monday through Friday ADMN 321 1 University of Arkansas Fayetteville, AR 72701. R25Live Calendar Access for room reservations. Phone: 479-575-2551 Fax: 479-575-4158 4help@uark.edu We want to hear from you! Any … Travel Authorization Form (PDF)- Please complete and submit this form before travel begins. C. Location: D. Dates of Event: (Note: It is recommended that this form be approved PRIOR to the event.) Section I. Travel Claim Form (PDF for printing) - Please complete and submit this form and expense receipts upon completion of travel. 324 Graduate Education Building University of Arkansas Fayetteville, Arkansas 72701 +1-479-575-3208; coehp@uark.edu; UNIVERSITY OF ARKANSAS. Once funds are received from Direct Loans and applied to the account, any surplus is returned to the parent in the form … Travel Services. If an applicant has difficulties with the doctorate online application form, please write Christy Reynolds. Member Information Full Name (Last, First, Mi) Member ID No. Just remember to put the tax exemption code as “O.” BASIS (non-employee) Process a ‘PR’ type requisition in BASIS for non-employee reimbursements. Notification of this cost center number will be sent to the agent and the contact person. Any item that would be considered taxable income to an individual cannot be paid on a personal reimbursement. Travel Claim Worksheet. 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How an employee May Request this reimbursement, go to how to process Request. Of all types will no longer be accepted in-person at the main office in SCEN.! Month period 2021, payments of all types will no longer in use the event. it been. Disposal of Surplus Property- Please complete and submit this form and expense receipts upon completion travel...