SoN Finance – Misc Payee Form – School of Nursing

SoN Finance - Misc Payee Form

Full Name(Required)

Type out exactly as it appears on your Social Security card.

Date

Event date

Are you a student at the University of Washington?

Yes

UW Student Identification Number

Are you a employee of the University of Washington – SoN?

Yes

UW Employee Identification Number

Best Time to Call You

Social Security Number (SSN) – please indicate the best time to call and best number in order for staff to connect with you to obtain your SSN

Select from the following:

US Citizen

Resident Alien

Non-Resident Alien

Your Address

Street Address

Address Line 2

City

ZIP Code

Mailing Address (if different from home address):

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Phone

Your Email Address

Email Address

Confirm Email Address

Activity Description

Compensation Rate

(i.e. hours/exams/sessions)

Total Units

Total Compensation Approved

For course number

(if applicable)

Budget to be charged

Approval Signature

Approving individual