Louisiana State University
Office of Accounting Services
Bursar Operations
125 Thomas Boyd Hall
ACKNOWLEDGEMENT OF CASH INCENTIVE PAYMENT AS549
Name of Workshop/Research Study
Account # Contact/Principal Investigator (PI) Phone
Dates of Participation to Approved by Date
LSUID Name Address City/State/Zip * Amt Received Signature
* Payments to nonresident aliens must comply with the procedures set forth in FASOP: AS-04
Rev 07/07
Print Form