Fillable As492 - AS492-Revised 10102017

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As492 - AS492-Revised 10102017

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Finance and Administration • Office of Accounting Services • Sponsored Program Accounting
240 Thomas Boyd Hall • Baton Rouge, LA 70803 • P 225-578-5337 • F 225-578-7217
EV 10/25/17
REQUEST TO ESTABLISH BASIC GIFT-LSU FOUNDATION AS492
 AS492 forms should be s  Emily Gregire (eg̷ǤȌǤ
General Information
Disclaimer: A University account number is no longer required to obtain security access to the BENGALs system and project ID(s) listed below.
on ct ID(Ȍ
Principal
Investigator (PI)
Bengals Descr
 Center Name  Center ID
d By 
 Ǧ
Function/Purpose
Please check all that apply as separate Basic Gifts are required for each function identified.
Instruon | ͳͲ Academic Su | FN40 Insti rt ȁ ͹Ͳ
Research | FN20 St Services | FN60 Operatons of Pla & Mance | FN80
Public Service | FN30 *Scholarship/Fellowship | FN90 Hospital | FN95
Approvals
*If Scholarship/Fellowship, please complete page 2. It is understood the Univerity will charge he current fringe benefits rate.
̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴__ ̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴ ̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴
Department Head (Required) Print Name Date
̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴__ ̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴ ̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴
Dean (Req
uired) Print Name Date
̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴__ ̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴ ̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴
LSU Fo
undation (Required) Print Name Date
Sponsored Program Accounting
Basic Gift Name
Basic Gift Name
 FD240 Restricted Private Gifts FD510 Stae Math Fs – Foundon Endowment
Basic Gift ID(s) Gift se(s)
 By 
LSUAM All Bc Gfts LSUAM Gift Fringe Group 1 (44%) LSUAM | LSU Foundation
L All Basic Gfts LSUAM Gift TR roup 1 (35%) LSUAG | LSU Foundation
LSUA All Bsic fts LSUAG Gift Fringe Group 1 (46%) LS ȁ U Founda
LSUE All Bsic fts LSUAG Gift TR Group 1 (35%) LS ȁ U Founda
LSU Foundation Autobill LSU Foundation Endowed Pro
Louisiana State University
Office of Accounting Services
Sponsored Program Accounting
240 Thomas Boyd Hall
Finance and Administration • Office of Accounting Services • Sponsored Program Accounting
240 Thomas Boyd Hall • Baton Rouge, LA 70803 • P 225-578-5337 • F 225-578-7217
REV 10/25/17
REQUEST TO ESTABLISH BASIC GIFT-LSU FOUNDATION
AS492
(Scholarships/Fellowships) – Page 2
General Information
Basic Gift ID FDM Translation (SPA only)
*For students not required to be enrolled as a condition of award or non-LSU students.
Criteria**
** Documentation of scholarship/fellowship criteria and other donor restrictions must be attache
d.
Approvals
______
__________________________________ ____________________________________________ _______________________________________
LSU Foundation (Required) Print Name Date
________________________________________ ____________________________________________ _______________________________________
Graduate School Print Name Date
Routing
Graduate Fellowship: LSU Foundation
Graduate School
SPA
Student Aid
Bursar Operations
Undergraduate Fellowship: LSU Foundation
SPA
Student Aid
Bursar Operations
Scholarship – Cash Award: LSU Foundation
SPA
Student Aid
Bursar Operations
Scholarship – Tuition/Fees: LSU Foundation
SPA
Bursar Operations
Student Aid
Please check all that apply: Spend Category
TRX Code
LSU Students
TRX Code*
Non-LSU Students
Graduate Fellowship (SAE) SC0111
Undergraduate Fellowship (SAE) SC0114
Scholarship – Cash Award (SAE) SC0112
Scholarship – Tuition/Fee Exemption (ABS) SC0112
Name of Scholarship/Fellowship
Cost Center Hierarchy Cost Center
Student Classification Major
GPA
(For Original Award)
GPA
(To Retain)
Full-time required?
Yes No
Amount
Semesters Awarded
Fall
Summer
Spring
Full Year
Number of Semesters/Years Student
can receive Scholarship/Fellowship
Online Semesters Awarded
First Fall (1L)
Second Fall (1P)
First Spring (2D)
Second Spring (2L)
First Summer (3D)
Second Summer (1D)
Other Requirements
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As492 - AS492-Revised 10102017

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Completed 15 February 2020

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