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SUNY Downstate Health Sciences University

Office of Development & Philanthropy

Payment Request & Voucher

Please deliver the completed Payment Request & Voucher form with supporting documents to Philanthropy through the SharePoint link below.  If re-submitting or submitting additional documents, please resubmit original documents or rescan packet to remove any documents that were revised or are not being submitted.

The completed Payment Request & Voucher and supporting documents will be transmitted to the HSCB Foundation after Philanthropy reviewed and approved.

 

3 EASY STEPS

Step 1

Step 2

  • Provide ALL the supporting documents based on the requirements below

Step 3

Requirements

Please read the requirements carefully and provide ALL supporting documents according to your specific payment request below.

 

Supporting Documents for Products or Services

  • Original Vendor Invoice with unique invoice # detailing specific, per item costs (for payment to a vendor or individual) made out to the HSCB Foundation, Inc.
    • Please note, Pro Forma Invoices will not be accepted.
    • No tax is allowed on payments to vendors
  • Letter/memo of Justification (for contracted payments, services, events).
  • All external contracts for independent contractors, venues for events, catering, etc. require Downstate Counsel review and must have HSCB Foundation approval before official confirmation or work can begin.

Payments to Individuals for Services Additional

Payments to Vendors Associated with Events, Meetings, Meals, and /or Travel Additional

Supporting Documents for Reimbursements

  • Original itemized receipts specifying item/s for reimbursement.
    • All receipts need to show the method of payment, and paid in full or zero balance
    • Incomplete credit card receipts may be supported with Credit Card statements showing: amount paid, date paid, vendor/purchase, card holder name and partial card number (e.g. last 4).  May redact other information.

Reimbursements for Events, Meetings, Reimbursed Meals, Travel Additional

  • Flyer/notice of event/agenda is required
  • Expense sheet is required
  • Letter/memo of Justification is required
  • Ticket Receipts are required and must show date/time/location of travel or corroborating documentation showing date/time/location of travel must be provided
  • An attendance sheet is required for meals, refreshments, and meetings

Supporting Documents for Honoraria

  • Letter/memo of Justification
  • W9 Form
  • IRS 20 Question Form
    • For honoraria for foreign national speakers without SSN#/TIN – omit W9/IRS 20Questions and note “Not a Citizen” in the lower right hand corner of the Payment Request & Voucher Purpose Section.
  • Flyer/notice of event/agenda is required
  • Expense sheet is required (when combined with travel or other reimbursements)

Supporting Documents for Scholarships/Awards

  • Summary memo/letter from a) the Committee Chair to the Signator or b) the Signator to the HSCB Foundation that includes:
    • The account name
    • The account number
    • The recipient/s’ name/s
    • Amount/s of award/s
  • Committee member list is required
  • Criteria for selection is required
  • Signature sheet is required (per Legal Counsel)
    • • Zoom (or other Distanced meetings) may be documented by email that includes: 
      • The date and time of the meeting,
      •  The method of the meeting (zoom or other distanced meeting)
      •  The recipient/s names
      •  The award amount/s
      •  Who decided on the recipient/s and how the decision was made.
      •  Note: every Committee Member should be CC’d in the email.
  • Call for applications is strongly recommended, please attach copy; if a call for applications was not done, an explanation is required (may be included in summary memo) detailing the process for determining the pool of potential candidates.
  • W9 Form is required with the permanent address (no Downstate Dorms)

Summary: All Payment Request & Vouchers & General Considerations

  • Fully Completed payment request is required.
  • Clearly Detail the purpose of the Payment Request in the Purpose section.
  • The Payment Request must be consistent with the purpose on file for the account.
  • The account needs sufficient funds to pay any Purchase Request/s.
  • The number of Signatures required on a Payment Request is determined by the Account.
  • Application, and all current signatures must be approved by the HSCB Foundation.
  • When the payee is a current signer, or the signer benefits from the Payment Request, an additional authorized signature is required.
  • Downstate Employees may receive reimbursement but may not directly be paid for services rendered.

 

 

Click Here to Submit Request

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