Socia
l Club Activity Certification and Log Form
(All sections of this form must be filled out entirely or it will be returned for completion. Submit to Procurement and Vendor Services (P2P), MS 1248)
Employee Name (PRINT): _____________________________________________ Ext. __________
Department: ___________________________________ Club Name: __________________________
I hereby certify that I used the ___________________________________________ (nam
e of club)
a total of _____ days. Of this total, I us
ed the club ______ days to conduct official Boise State
University business and ______ days for personal activities. I un
derstand that if this log fails to meet
the substantiation requirements set forth by the IRS, the entire value of the membership may be treated
as taxable compensation to me.
Signature: ___________________________________________________ Dat
e: ______________
Check appropriate box for this submission:
1
st
Quarter Dec–Feb (due to P2P by 3/5)
2
nd
Quarter Mar–May
(due to P2P by 6/5)
3
rd
Quarter Jun Aug (due to P2P 9/5)
4
th
Quarter Sep – Nov (due to P2P 12/5) OR
I elect to treat the entire benefit a
s taxable
compensa
tion. (If this box is selected, you must submit
this form to P2P by Dec. 1 annually. Tax due on this
benefit will be deducted bi-weekly from your paycheck
over the course of the year.)
DATE
PARTIES PRESENT
B or P*
BUSINESS PURPOSE (be detailed, i.e. “donor cultivation” not adequate)
Sample
Joe Employee and Susan Donor
Met with Susan Donor, CEO of ABC Inc., headquartered in Boise, ID, for lunch to
discuss progress on COBE fundraising and to solicit additional $1 million donation
from ABC Inc. for construction of new Business Bldg.
Rev. 04/20
Socia
l Club Activity Certification and Log Form
(All sections of this form must be filled out entirely or it will be returned for completion. Submit to Procurement and Vendor Services, MS 1248)
PAGE ____ (IF YOU NEED MORE SPACE, USE ADDITIONAL COPIES OF THIS PAGE AND INSERT PAGE NOS.)
Employee Name (PRINT): ____________________________________________
Club Name: _____________________________ QUARTER NO. _______
DATE
PARTIES PRESENT
B or P*
BUSINESS PURPOSE (be detailed, i.e. “donor cultivation” not adequate)
Rev. 04/20
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