Office of Research & Sponsored Programs
STIPEND/FELLOWSHIP ACKNOWLEDGEMENT
(Note: For payments unrelated to University
employment or consulting contracts)
R
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c
ipien
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ID (if
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Term
:
Fall
20
Sp
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in
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20
Su
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20
CSUEB Student=
Non-Student/Non-CSUEB Employee=
R
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c
ipien
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Signatu
re:
Da
t
e:
I acknowledge that no taxes will be withheld from the payment(s) I will be receiving. I
also acknowledge that the payments I will be receiving may be reportable to the IRS on IRS
Form(s) 1099-MISC or 1098-T, which California State
University,
East Bay, if required, will file
with the IRS and mail me a copy or provide me with an electronic copy of the form(s) filed.
Financial Aid: If applicable, acceptance of t
his stipend/scholarship may affect
your current and future financial aid package. It is your responsibility to work with
Financial Aid personnel to understand the impact of this award on your financial
aid.
Ta xable Income: Recipients should seek the advice of a qualified tax advisor if
he/she has any questions regarding the taxability of these payment(s) or deductible
expenses.
I have read and accept the conditions of my stipend (unrelated to university employment/consulting):
Pr
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P
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field
:
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Ph
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a
to
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na
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Da
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Other:
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