Forms
Accounting
| Form Link | Description | Last Updated |
| Banner LDCA Form | This form is to be used to authorize a change in labor distribution for one employee for a prior period. | 02/27/12 |
| Banner Access Request | Form to request UConn Health Banner access. | 09/08/22 |
| Check Tracer | Form to request tracking of potentially lost UConn Health vendor/reimbursement checks. | 09/22/17 |
| Conference Facility Reservation | Contract hotel and conference facility authorization. | 08/26/11 |
| IRS W-9 | IRS taxpayer identification form. | 07/07/11 |
| Mileage Reimbursement – old rate | Form for mileage reimbursement rate effective 07-01-2022. | 07/22/22 |
| Mileage Reimbursement – new rate | Form for mileage reimbursement rate effective 01-30-2023 | 01/30/23 |
| Miscellaneous Payment Reimbursement | Non-PO expense reimbursement form. | 07/25/22 |
| Remittance Form | Institutional deposit form. | 01/26/22 |
| Signature Authorization | Signature Authority will be granted to the requesting employee listed at right for the following funds and organizations. | 09/08/22 |
| Stipend/Fellowship | For use in requesting payment for research subjects/student stipends/student awards. Please note that this form requires B numbers, available via the Person Lookup tool. | 07/07/11 |
| Transfer Invoice Form CO-608 | Transfer Invoice for billing between State entities. | 09/22/17 |
| Miscellaneous Transfer Voucher | Transfer voucher for billing between UConn Health departments or requesting a journal voucher. | 08/05/11 |
| Travel Reimbursement – old rate | Form to obtain reimbursement for allowable UConn Health business travel expenses, on or before January 29, 2023. | 07/25/22 |
| Travel Reimbursement – new rate | Form to obtain reimbursement for allowable UConn Health business travel expenses, on or after January 30, 2023. | 06/01/23 |
Accounts Payable
| Form Link | Description | Last Updated |
| Vendor Payment Authorization | This form may be used when requesting a payment to a vendor for the following: license renewal, subscription renewal, membership dues, etc. | 08/01/2022 |
Budget
| Form Link | Description | Last Updated |
| Budget Reallocation | Budget Reallocation Forms will not be processed unless detailed accounts are used. | 08/08/22 |
| Strata Budget Instructions | Strata Budget Instructions for Basic Users | 08/03/22 |
| Strata User Access Request Form | Form to request or update access to Strata Budget software | 08/03/22 |
| New Fund Request | This form should only be used for requesting new funds. | 08/28/12 |
| Capital Contingency Request Form | This form should be used for requesting capital item purchase approval. | 02/02/21 |
Travel and Cash Management
| Form Link | Description | Last Updated | |
| Branch Fund Request | This form is used to establish a “petty cash” fund. Branch Funds are used to make change for patient payments, or miscellaneous emergency purchases. | 09/09/22 | |
| Branch Fund Reporting | Explain any discrepancy between this total and the Authorized Balance. Note: Read the updated Branch Fund Procedures. | 03/22/19 | |
| FERPA Release Form | This form must filled out for the Travel and Cash Management Office to discuss any/all billing matters with a designee set up by the student. Without this form the office cannot release any information to anyone other than the student enrolled. | 10/31/17 | |
| Remittance Form | This form must accompany any and all deposits for cash and checks. Please fill in all information or deposits will not be able to process. | 01/26/22 | |
| Remittance Form – Patient Services | Use this form to deposit patient service payments made by coin, cash, or check. Please fill in all information or deposits will not be able to process. | 05/18/18 | |
| Remittance Form – Patient Services – Credit Cards Only |
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05/18/18 | |
| Vendor Credit Card Application | This form is used to apply for a credit card terminal and merchant number to do business on behalf of the institution via credit cards. | 02/08/23 | |
| Virtual Conference Authorization Form | Use this form to authorize virtual conferences that are presented online, do not require travel from your duty station, and do not have additional costs other than registration. | 07/01/21 |
Travel
| Form Link | Description | Last Updated |
| U.S. Visa History Form | Is strictly confidential and is not associated with immigration or visa classification. It is used for tax withholding and needs to be filled out when a Social Security Number is not available. | 10/31/17 |
| Bradley International Airport Parking Map | Map of the state authorized parking areas at Bradley International Airport, for official travel. | 02/27/12 |
| Function Booking Sheet | All events booked using institutional funds must be approved prior to services being processed. | 05/27/11 |
| Guest Travel Authorization | This form must be completed and authorized before it is considered valid. All guests or candidates must be on file in the Travel and Cash Management Office. | 01/30/23 |
| Hotel/Facility Authorization | Use this form for making reservations with an approved guest TA. Provide hotel a copy of form. Complete all information. If UConn Health charges admission, not tax exempt. If UConn Health doesn’t collect revenue, it is tax exempt. | 05/27/11 |
| Travel Authorization Request | This form must be filled out for any and all travel, including no-cost to state travel. All signature authorizations must be filled in for a TA to be considered AUTHORIZED and VALID. | 01/30/23 |
| Travel Advance Request | Complete sections A and B and forward to Travel and Cash Management Office, 16 Munson Road, MC 5105. | 10/31/17 |
| UConn Health Corporate Credit Card | Form to apply for a UConn Health corporate credit card. | 09/19/11 |
| Exception to Travel Policy Request | This form should be completed to request approval for expenditures that are not allowed within the travel policy but which the traveller would like to be considered for reimbursement | 7/11/17 |
| Travel Reimbursement Checklist | A one sheet guide for pre-checking travel submittals prior to sending for processing | 12/01/17 |
| Business Meal Request Form | This form is used to request pre-authorization for a business meal associated with a valid business purpose. It requires an agenda, attendee listing, and consideration of per diem cost caps. | 03/15/19 |