Winthrop University Foundation
WUF-D Disbursement Request
Complete this form and attach original receipts or invoice prior to submission.
Return to: WUF Finance Office, 302 Tillman Hall
Rev. 09/2014 Page 1
Date Prepared: □ Hold Check for Pick-Up
Payee Name: Amount : $
Payee Relationship: □ WU/WUF Employee □ WU Student □ Individual
□ Established Vendor* (Documents on File)
□ New Vendor* - If this is your first request for this vendor, please complete the following:
Federal Tax ID: □Form W-9 attached, see box*
Mailing Address:
City: State: Zip:
Fund or Account Description:
Foundation Fund ID or Account Number
Invoice #
In the space provided below, please write a concise description of the
business justification for the expense, including the benefit to Winthrop University:
Prepared By: College/Department
Preparer Signature Campus Address Phone Ext
Authorizing Signatures: By signing below, I certify that
• I am the current authorizing official for the fund indicated.
• The expenditure is a usual and customary business expense that furthers the mission of Winthrop or WUF.
• The request is in compliance with the established purpose of the fund and with Foundation reimbursement policies.
• The expenses have been approved by the University, as required by policy and have not been reimbursed or paid from any other source.
Authorizing Official: (Print) Title
Authorizing Official Signature Date
Please note: The payee indicated may not authorize his/her own reimbursement. The payee’s immediate supervisor and the approving Dean, Department
Head or VP must authorize the request.
Dean, Dept. Head/VP Signature Date
We welcome your questions – please call x2229 or email Brenda Floyd floydb@winthrop.edu or Robin Embry embryr@winthrop.edu.
Please review the following reminders to expedite your request:
Please remember to submit all supporting documentation required. Tape the original receipts to a blank piece of paper and staple all other
supporting documents to this form and indicate the following:
o Signatures - be sure to have the person completing the request and the Authorizing Official(s) sign the WUF-D, and WUF-D2 (if needed).
o The Authorizing Official should hand write ‘Ok to pay’ and initial the related invoice.
The information required meets an external audit requirement. Incomplete requests will be returned for correction prior to processing.
Verify that the request complies with the Winthrop University Foundation’s Travel and Entertainment Policy.
Please note:
*If the request for payment is for
profess
ional services or honoraria, attach
a completed IRS Form W-9 form
(download from www.irs.gov/pub/irs-
pdf/fw9.pdf)
**For all food/beverage supplies or meal
purchase, we are required to identify the
purpose of expense and all people attending,
including each person’s relationship to
WU/WUF. You may use the roster provided
on WUF-D or create your own with all
required information.
*** If your request is for business-related
mileage reimbursement, please attach
WUF-E form available at
wufoundation.com.
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