♦ … 1 0 obj Monthly Time Sheet for Non-Exempt Employees. QualChoice Medical Services Claim Form (PDF) Submit Prescription Drug Claim form for prescriptions paid for in full. Request for Disposal of Surplus Property- Please complete and turn in at the main office in SCEN 601. Member Information Full Name (Last, First, Mi) Member ID No. Google+. Travel Office Staff. 1 University of Arkansas Fayetteville, AR 72701 Phone: 479-575-5451 Fax: 479-575-4651 Email: registra@uark.edu. TOTAL: (May not … Procurement Card Report. ��DA�Z||Z%���idQ>l��&RM����vxg���#�iz��259���4.wx�V{�n���%�X�ѯ6��쾼��_.7�����/���Oӻ�a�����>n���r�)W��X�b��6u��!$� .�������W5Tp�[_����x�L���)9S���a?�Lq��J,p��%b��_ �ف_J��>���L{s�m��K*�b?�H`�O�>h]���. Membership Justification Form: Any time a membership is purchased in conjunction with a conference registration, this form must be attached with the other claim documentation. (If you have an … Fulbright College Substitution and Exception Request Form, Out of Career Registration Instructions and Form, https://graduate-and-international.uark.edu/graduate/current-students/forms.php, Meals and Entertainment Justification Form, R25Live Calendar Access for room reservations. By allowing you to pay for certain benefits such as: ♦ Employee contributions toward health insurance premiums. To establish a new imprest fund, submit a completed Request for Imprest Fund form to the Financial Affairs Compliance Office that includes the following information: Justification for intended use of the fund; Justification for the amount of money requested ; Dean or department head approval; All requests approved by the Financial Affairs Compliance Office will be then forwarded to the Chief Fiscal Officer … Travel Guide: Things to know when traveling for the University of Arkansas. This includes Memberships purchased through personal funds, TCards or TRPOs. stream File a Reimbursement Request Form … 8:00 a.m. - 5:00 p.m. The only form … Follow Us on Facebook . PAYMENT CHECK: FOR: Reimbursement for emergency expenditure(s) as follows: DATE PURCHASED. On the Home/Shop screen of RazorBuy, click forms located under the search bar. ANTH Personnel Form. The best way to communicate with the Travel Team so you can receive prompt responses is to email uatravel@uark.edu.All members of the Travel Services team monitor the uatravel@uark.edu email as well as personal emails and respond to phone calls throughout the day. COST . Visit. C. Location: D. Dates of Event: (Note: It is recommended that this form be approved PRIOR to the event.) Even though the Travel Claim is entered and submitted via TARGET for approval, a printed Travel Claim will need to be signed by the traveler. Departmental Forms. Admissions; Academics; Campus Life; … Visit the Travel Services website for additional travel links and information ==> https://travel.uark.edu/. (excluding co-pay) PharmaCare Pharmacy Claim Form (PDF) Flexible Benefit Plan. COVID-19 Travel Form; GENERAL UNIVERSITY RELATED UPDATES ON CORONAVIRUS (COVID-19) University Travel Restrictions; Workday Information. As of Fall 2020, we are implementing an acceptance deadline for all employee and spouse/dependent waivers. 4 0 obj endobj The IRS allows reimbursement for services when the care is provided, which may not be the actual date that the patient pays or is formally billed for the charges. Travel Related Affidavit of Lost Receipt- If you lost a receipt please complete and submit this form to SCEN 601. Submit claims within the filing … Senior Exit Interview Survey; Masters Forms. Member Reimbursement Claim Form . White, Jr. Engineering Hall 790 W. Dickson St. Suite 120 Fayetteville, AR 72701 Phone: 479-575-4667 Fax: 479-575-5619 Describe event and benefit to University of Arkansas: Business Services . Employees of OTHER CAMPUSES of the University of Arkansas System, including the Agricultural or Cooperative Extensions, YOU MUST complete your specific institution’s waiver form. Personal Reimbursement Form - Complete and submit with receipts and Meals and Entertainment Justification Form if applicable. ♦ Amounts for medical expenses that are not covered by your other insurance (such as deductibles or co-payments). A new Travel Claim process in BASIS is replacing the paper form, ‘Statement of Traveling Expenses’. To use this form you must first login to RazorBuy. Any item that would be considered taxable income to an individual cannot be paid on a personal reimbursement. If a student is changing from a degree in one program into another degree program, they must submit a new admissions form. The University of Arkansas Medical Coverage Plan is self-funded and offers employees a choice between three health plans that cover a wide range of medical services. Do not submit cancelled checks or credit card receipts alone. (Open using Internet Explorer browser). CLAIM FORM INSTRUCTIONS Please read carefully before completing this form. COST TOTAL: I hereby certify tha t the items described herein were purchased for the University of Arkansas and were paid for from persona l funds. R25Live Calendar Access for room reservations. Request for Change of Program Form (This fom is no longer in use. Payments can be made online by e … Affidavit for lost/stolen check. is CCNE-accredited and provides flexible degree plans for … <>/XObject<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 756 576] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Business Services. If you have a positive test result, you will be reassigned to a temporary room where you can isolate until you have been released by your medical provider or the Arkansas Department of Health. Beginning spring 2021, payments of all types will no longer be accepted in-person at the Treasurer's Office. Please include Name, Title, and Company/Institution. Find Workday Support Services, including Training, on the UA … The University extends the employment benefit of a tuition waiver as established through Board Policy 440.1.The administration of this employee benefit at the Fayetteville campus is defined in Fayetteville Policies and Procedures 512.0.The Employee Tuition Waiver Chart provides a Definition of Terms regarding eligibility and details regarding waivers for Employees and … R.N. View benefits, enroll, waive, or contact Customer Care. UNIVERSITY OF ARKANSAS EMPLOYEE REIMBURSEMENT CLAIM FORM. Use this form for reimbursement of services received from an out-of-network provider, or when you have utilized an in-store sale or promotion from an in-network provider. At the University of Arkansas, we value our employees and recognize them as our organization’s greatest asset. Personal Reimbursement Form - Include the Workday Worktag in the appropriate field or the reimbursement will not be processed. If an applicant has difficulties with the doctorate online application form, please write Christy Reynolds. Affidavit of Lost Receipt. You will also receive a system generated email regarding your payment once it has been processed. Katherine E. Murray, Assistant Director of Benefits kem051@uark.edu. endobj Additional Graduate Student forms can be found at http://grad.uark.edu/forms/degreeforms.php Personal Reimbursement Form - Complete and submit with receipts and Meals and Entertainment Justification Form if applicable. Complete the employee section (pages 3 and 4) of the University of Arkansas Long-term Disability Conversion Insurance form. Access Workday through the Workday App Located at myapps.microsoft.com and login with your university credentials. Teacher Education. Subscriber Information (Please print clearly) Subscriber Name Daytime Phone ( ) Evening Phone ( ) Mailing Address City State Zip Subscriber ID Number Name of Employer . Visit the university's main page about quarantine and isolation procedures for the latest information.. Office of Financial Aid 114 Silas Hunt Hall 1 University of Arkansas Fayetteville, AR 72701. Form W-9S Request for Student's TIN. How? Graduate Student Employee Application-Please complete and turn in at the main office in SCEN 601. Phone: 479-575-2551 Fax: 479-575-4158 4help@uark.edu Legal Review Form. Begin New Flexible Benefit Plan (requires- New eligibility or Qualified change) Flexible Benefit Plan Enrollment Form (PDF) Request … Once final approval has been granted for monetary reimbursement for an employee-owned device, the Cellular Communication Justification and Approval form must be forwarded to the accounts payable office. Department of Biological Sciences Science and Engineering, Room 601 University of Arkansas Fayetteville, AR 72701, P 479-575-3251 F 479-575-4010 E-mail: dmcnabb@uark.edu. Contact Phone No. No reimbursement will be allowed to any traveler for personal entertainment, clothing, valet services (unless that is the only parking available at the hotel), flowers, alcoholic beverages, personal telephone calls, traveler's check service charges, laundry or cleaning, printing items, or any other items not considered to be official business expenses unless specifically authorized by the Travel Office and … Accounts payable will develop a database of the approved reimbursements that will include the employee name, employee title, budgetary unit, company cost center, departmental category, the term … Treasurer's Office, located in the Arkansas Union, Room 214 from 8:00 am to 5:00 pm Monday through Friday Travel Claim Form (PDF) Travel Claim: Third Party Reimbursement (PDF) Financial Resources. Participants must submit a monthly Reimbursement Request Form to UMR. ITEM DESCRIPTION. The Eleanor Mann School of Nursing's program Registered Nurse to Bachelor of Science in Nursing (R.N.-B.S.N.) Travel Guide: Things to know when traveling for the University of Arkansas. University of Arkansas To see the process of how an employee may request this reimbursement, go to How to Process a Request for Cell Phone Reimbursement. Surplus Request Form - Inventory Accounting and Finance. to B.S.N. When asking for reimbursement for meals that fall under the Official Function Policy of the U of A, an itemized meal receipt is always required. We want to hear from you! Extra Compensation Form. Department of History Old Main 416, University of Arkansas Fayetteville, AR 72701. Phone: 479-575-3806 FAX: 479-575-7790 finaid@uark.edu. Employee Reimbursement Claim - The only time that you are allowed to be reimbursed for purchases you made … Each plan has four coverage levels: employee, employee and spouse, employee and children, or family. Part 1: Member Information (to be completed by the member) 1. Department of Biomedical Engineering John A. REIMBURSEMENT CLAIM FORM - MOVING EXPENSES BU PAYEE TIN NUMBER DATE OF MOVE PO NUMBER AP ID CCI CCC SPECIAL NOTES: QUALIFIED EXPENSE NON-QUALIFIED EXPENSE (NON-TAXABLE) (TAXABLE) EXPENSE TYPE BOX 13 OF W-2 BOX 1 OF W-2 Actual Cost of Move Transportation (one-way) Hotel * Meals (always Non-Qualified) House Hunting (always Non-Qualified) Family Move … The Health Insurance Claim Form (CMS 1500) HIPAA and Electronic Data Interchange (EDI) Review and practice coding Evaluation and Management (E&M) services; Review and practice coding from anesthesia, surgery, radiology, medicine, and the pathology/laboratory sections of the CPT CPT Modifiers, E and V Codes and Late Effects; Coding surgical and medical procedures for the cardiovascular, … ADMN 321 1 University of Arkansas Fayetteville, AR 72701. All payments received by mail during this time were processed on January 2, 2019 and will be included on the 2019 1098-T form. E. EstimatedMeetingExpenses: Notes: … For each The University of Arkansas was closed December 22, 2018 to January 2, 2019. Notification of this cost center number will be sent to the agent and the contact person. If you are not employed by the University, please email wechever@uark.edu. <> Official Function Form . complete the employee reimbursement form be sure to enter the full amount being reimbursed (including tax) into the price do not mark the cart as taxable. The University of Arkansas has partnered with BankMobile, a division of Customers Bank, to deliver financial aid and other school … Employee Reimbursement Form; Sole Source Justification Form; Additional Forms; Travel Forms Forms to be completed PRIOR to travel: Travel Authorization form – to be completed and turned into department rep prior to travel. Graduate Student Forms. Per the University of Arkansas Cellular Communication Policy, appointed employees who are eligible, may request a cell phone reimbursement. Human Resources 222 Administration Building Fayetteville, AR 72701 479-575-5351 Fax: 479-575-6971 Department of Biomedical Engineering John A. Documents must support claim that student may not be afforded the opportunity to attend the University of Arkansas because of extreme financial strain caused by the expense of living on campus, and that cost of living off campus is significantly less expensive than living on campus. Your one stop for managing your student health insurance plan. Login to webBASIS via the Employee/Affiliate login, using your UARK ID and UARK Password. Off-Campus Property … Complete the non-employee … Now, the next time you have a reimbursement that is processed, whether that be a Travel Advance, Cell Phone Reimbursement, or other type of Reimbursement, the payment will be directly deposited into your bank account. Parent Plus Loans (PPL) A Master Promissory Note (MPN) is required before funds can be disbursed. 525 Old Main Travel Authorization Form (PDF)- Please complete and submit this form before travel begins. Once funds are received from Direct Loans and applied to the account, any surplus is returned to the parent in the form … career. EMPLOYEE REIMBURSEMENT CLAIM FORM. Street Address City State ZIP CAMPUS of Employee (PLease CheCk One) ASMSA UAM CES UAMS UAF UAPB UACCB WRI UALR PCCUA Other: Section II. Out-of-Career Registration is for those who wish to take a course out of their academic Travel Claim Form (PDF for printing) - Please complete and submit this form and expense receipts upon completion of travel. Travel Authorization Form (PDF)- Please complete and submit this form before travel begins. Manage UARK Password Main Office: 1083 East Sain Ave. Campus Office: 146 Silas H. Hunt Hall . Phone: 479-575-2551 Fax: 479-575-4158 4help@uark.edu Cash Advance Agreement Form. Contact Us; Customer Satisfaction Survey; Additional Links; Financial Affairs ; Financial Aid; Registrar's Office; University Housing; Razorbuck$ Site Last Updated 1/11/2021 8:23:31 AM. Form W-9S Request for Student's TIN. Out of Career Registration Instructions and Form - Out-of-Career Registration is for those who wish to take a course out of their academic Lists for Locating Employee Reimbursement Requests; Below are helpful lists available for locating employee reimbursement requests: Lists Available in 3270 BASIS. Then click on the form name or View Form, this will open the form in a new window. P 479-575-3001 F 479-575-2775 E-mail: mmadams@uark.edu What items cannot be paid on a personal reimbursement? %PDF-1.7 Travel Authorization Form (PDF)- Please complete and submit this form before travel begins. B. Attendees: Attendee list should include state and non-state employees. College of Education and Health Professions. This form supplies the necessary agent information and includes the terms of the advance. ; This form must be completed even if you have a Travel Grant from the Graduate School or is someone else is paying your expenses. 2. Mileage Log Worksheet Fulbright College Substitution and Exception Request Form-This form is used to request substitution, exception, or waiver of major and/or minor Department of Biomedical Engineering John A. An accounts receivable cost center number will be assigned to each new agent. DEPARTMENT: DATE: PAY TO: REMITTANCE ADDRESS FOR PAYMENT: FOR: Non-employee reimbursement claim as follows: DATE PURCHASED. Do not submit balance forward statements. Per the University of Arkansas Cellular Communication Policy, if you are eligible to receive a cell phone reimbursement on a monthly basis, you will do so by requesting a Personal Reimbursement via webBASIS.Below is a Step by Step Guide for requesting a recurring monthly reimbursement. Reimbursement Request requirements only. Personal Reimbursement Form - Include the Workday Worktag in the appropriate field or the reimbursement will not be processed. Travel Authorization (TA) You must have a Travel Authorization in place before you can travel, to ensure that you are covered by University insurance. Patient … career. COVID-19 Domestic Travel Appeal Form. Anthony Travel: When using a University TCard, use of our Travel … Health Care Reimbursement Dependent Care Reimbursement INTRODUCTION A Flexible Benefit Plan reduces your taxes and could enhance your benefits package. Personal Reimbursement Claim Form. 750976 SI 2047 3 of 7 (5/19) University of Arkansas at Fayetteville Disability Insurance Claim Form Fraud Notices Standard Insurance Company 888.641.7194 Tel 800.378.6053 Fax PO Box 2800 Portland OR 97208 Some states require us to provide the following information to you: ALABAMA, MARYLAND AND RHODE ISLAND RESIDENTS Any … Travel Claim Worksheet (Excel)- Please complete and submit this form and expense receipts upon completion of travel. Wire Transfer Form . Fill out all required fields (in bold) and all relevant information. See the application … endobj 324 Graduate Education Building University of Arkansas Fayetteville, Arkansas 72701 +1-479-575-3208; coehp@uark.edu Fulbright College Writing Requirement Form, Override/Administrative Change of Registration Form. This is a calculated field which shows the difference between the Claim Total, Traveler Card purchases and Travel Advance. DEPARTMENT: DATE: PAY TO: ADDRESS FOR . T Card Forms (Interactive PDF) T Card Employee Agreement Form; T Card Lost/Unobtainable Receipt Form; T Card Delegation Form ; T-Card Dispute Form . Do not … See Personal Reimbursement Procedures for additional information.) If you need alternatives (written) documents or forms, contact Business Services at (479) 575-2551 or 4help@uark.edu. Business Services. This form should be signed by the person claiming reimbursement. University of Arkansas 321 Administration Building Campus Mail Stop: ADMN 321 Fayetteville, Arkansas 72701; P 479-575-2551; uatravel@uark.edu University of Arkansas 321 Administration Building Campus Mail Stop: ADMN 321 Fayetteville, Arkansas 72701; P 479-575-2551; uatravel@uark.edu; UNIVERSITY OF ARKANSAS. Just remember to put the tax exemption code as “O.” BASIS (non-employee) Process a ‘PR’ type requisition in BASIS for non-employee reimbursements. Include actual dates of service on the claim form. White, Jr. Engineering Hall 790 W. Dickson St. Suite 120 Fayetteville, AR 72701 Phone: 479-575-4667 Fax: 479-575-5619 They help people accomplish tasks safely, quickly and … Employee Resources Emergency Contact Form - Please complete a new form if anything with your contact information changes. Out of Career; Graduate Credit for 3000-4000 Level Courses; Undergraduate Forms. Careers are AgLaw, Law, Graduate and Undergraduate. REIMBURSEMENT CLAIM FORM DEPARTMENT:_____ DATE: _____ PAY TO: _____ (Must normally be a Universi ty employee. Search for Workday or scroll down the page until you see the Workday App. Contact HR at 479-575-5351 or hrbenf@uark.edu to request the form to convert your long-term disability insurance. The form and commodity code lets the system know it is non-taxable. Personnel Forms. These are not adequate documentation without supporting itemization. Reimbursement forms should be turned in to Caitlin Gragg - acgragg@uark.edu; Requisition Form; Membership Justification Form; Payroll Evaluation of Graduate Student Progress for Biology Graduate Students, Additional graduate student forms can be found at https://graduate-and-international.uark.edu/graduate/current-students/forms.php. The Travel Office strives to provide the highest level of customer service to the campus community. IRS Form 1098-T (Tuition Payment Statement) DEPARTMENT: DATE: PAY TO: VERIFICATION OF ADDRESS FOR PAYMENT: FOR: Reimbursement for emergency expenditure(s) as follows: DATE PURCHASED. Travel Claim Worksheet. Patient Information. LRBT (List Reimbursements for a BU and Type allows you to view a list of employee Reimbursement Requests by a Specified Budgetary Unit and Reimbursement Type. Apply. ; A Student Code of Conduct While Traveling form … Direct Deposit Authorization Form. Travel Guide: Things to know when traveling for the University of Arkansas. Any … Personal Reimbursement Form - Complete and submit with receipts and Meals and Entertainment Justification Form if applicable. (Note: May provide list as an attachment.) Once this accounts … Federal Per Diem Rates; International Travel – Student request form– use this form to register travel through Office of Study Abroad for any … Hourly Employee Application-Please complete and turn in at the main office in SCEN 601. 3 0 obj 2. 2 0 obj To assist programs with the payment process, each unit is asked to utilize the following guidelines in their planning: In preparation for the visit, please email the Director of Curriculum Review and Program Assessment the contact information for the college representative that will be processing the costs related to the visit. Financial Aid Disbursement Spring 2021. Extra Compensation Companion Form. ADDRESS FOR PAYMENT CHECK: _____ FOR: Reimbursement for emergency expenditure(s) as follows: DATE PURCHASED ITEM DESCRIPTION COST TOTAL: (May not exceed $200.00 without special … Submit Health Care Claim form for services previously paid for. COST. Time Sheet for Hourly Workers. Per the University of Arkansas Cellular Communication Policy, if you are eligible to receive a cell phone reimbursement on a monthly basis, you will do so by requesting a Personal Reimbursement via webBASIS.Below is a Step by Step Guide for requesting a recurring monthly reimbursement. Surplus Request Form - Inventory Accounting and Finance. Personal Reimbursement Form - Complete and submit with receipts and Meals and Entertainment Justification Form if applicable. … UNIVERSITY OF ARKANSAS NON-EMPLOYEE REIMBURSEMENT CLAIM FORM. Overview. Educational Technology. Any financial aid received in the form of a paper check with the student listed as a payee requires an endorsement after it is in the possession of the University Cashiers Office (ARKU 214) before it can be disbursed. The Treasurer’s Office will process your approved TA request, and posts the … Careers are AgLaw, Law, Graduate and Undergraduate. The signed claim … The member/cardholder ID Number is located on your insurance card. This includes Memberships purchased through personal funds, TCards or TRPOs. Travel Services. Online. College of Education and Health Professions. The following information should be provided with this form: 1) Explanation of circumstances why a purchase order was not used. A. praborn@uark.edu. Membership Justification Form. Submit your approved TA request to the University of Arkansas Treasurer’s Office for processing (email to Cole Teaster at ncteaste@uark.edu and cc Jordan Campbell at jtcampbe@uark.edu, PDF format). Once the traveler has returned from their trip, they need to organize all of their required receipts so they can obtain reimbursement for authorized expenses. Claim forms without the required information cannot be processed and will be returned to sender. Complete all information under Part 1. Industrial engineers are often called “big picture” engineers, because they look at systems as a whole and come up with ways to improve them. 1 University of Arkansas Fayetteville, AR 72701 Phone: (479) 575-2352 Fax: (479) 575-2846 . Contact Us; Customer Satisfaction Survey; Additional Links; Financial Affairs ; Financial Aid; Registrar's Office; University Housing; Razorbuck$ Site Last Updated 1/11/2021 8:23:31 AM. 324 Graduate Education Building University of Arkansas Fayetteville, Arkansas 72701 +1-479-575-3208; coehp@uark.edu; UNIVERSITY OF ARKANSAS. TOTAL: (May not exceed $5000.00 without special authorization) I hereby certify that the items described herein were purchased for the University of … Department of Biological & Agricultural Engineering 203 Engineering Hall 1 University of Arkansas Fayetteville, AR 72701 Phone: (479) 575-2352 Please submit override form from your uark student email account. fulbright@uark.edu, Links to important University of Arkansas pages. In order to remain eligible to receive advance, each active agent must sign an agreement form each 12 month period. <>/Metadata 142 0 R/ViewerPreferences 143 0 R>> <> Reimbursement forms should be turned in to Caitlin Gragg - acgragg@uark.edu; Requisition Form; Membership Justification Form; Payroll University of Arkansas Accounts Payable; University of Arkansas Travel Office; University of Arkansas Surplus ; University of Arkansas Procurement Card; University of Arkansas Student Tuition and Fees Information ; Fee Waivers for Employees, Spouses and Dependents; University Property. Payments that were mailed and received prior to December 22, 2018 are included on the 2018 1098-T form. ADMN 321 1 University of Arkansas Fayetteville, AR 72701. ITEM DESCRIPTION. Fayetteville, Arkansas 72701479-575-4801 tcdocs@uark.edu is the email address to send Admin TCard documentation ONLY ... Any time a membership is purchased in conjunction with a conference registration, this form must be attached with the other claim documentation. %���� ITEM DESCRIPTION. U of A Fulbright College; Departments & Schools; Political Science; Resources; Faculty Resources; Faculty Resources . Reimbursement for Meals that fall under the Official Function Policy (Not on Travel Status): This is in reference to meals being reimbursed primarily through the Purchasing Office unless you are an employee who has a Traveler TCard through the Travel Office. Office Hours: M - F 8:00 a.m. – 5:00 p.m. Travel Services. x���n�F�݀�a��"�9w�N�M�n����E�E�mn%˕����̐�H�Q�[��9g����_�6��t��?\�?NO2��Y��\K)�u�z'V����.NOο{o����D��zr�d����ۿ�����D��]��O�����޽�Ņ�|}��i?G�e�4���H�?q�}��vR��ilX�S%�'�{6�ac@ጁ�.+���� $�I�\h�Rc��mZ81����-�w�����T��@�j��g@�H�V�4W�@A ͧ�!��R9{u�����J����ū�#���ȅ5N\�J\� }�[/ :�1�����ə�L�3;�+93�er�&�˧DO�$����OO�\�_�9L%d��2*�] f�7���2) �'e�@ Please note: It may take two business days before your payment is posted to your bank … 1. Fulbright College of Arts & Sciences Section I. White, Jr. Engineering Hall 790 W. Dickson St. Suite 120 Fayetteville, AR 72701 Phone: 479-575-4667 Fax: 479-575-5619 Official Function Form. Click the Employee Reimbursement folder from the side menu.