Transaction Request Form

Transaction Request Form

To help us fulfill your request, please complete this form as completely as possible.

Informational Websites:

Workday Requests - Additional Pay Form Additional pay includes allowances, one-time payments, period activity pay, and temporary increases to hourly rates/salaries. Acting Rate Form

Mileage Request Reimbursement - If the director of your division deems it necessary for business reasons and the division’s operating budget can support it, you may submit for reimbursement for your normal commuting distance when a personal vehicle is used for university business. A memo from the division’s director must be on file in the Provost Administrative Affairs Finance Office noting the approval for this exception for the entire division, the business justification for this exception and acknowledgement that the division’s budget can support this additional cost. This memo must be renewed annually by the director.”

Contracts - Per University policy, all purchasing contracts must be executed (signed) by authorized individuals in Procurement Services.

Supplier Search

Paying a student (decision tree)

Individual Service Provider - If an individual is providing a service and has not gone through this process, you must submit to Corporate Tax, Compliance, and Payroll for review and final determination via a BEN Helps Support Ticket, the Service Provider Questionnaire and Evaluation PRIOR to submitting an invoice for payment or supplier request. If we are paying an LLC please verify with the company if they are a single employee. If there are multiple individuals in the LLC, you will not need to submit a SPQ or SPE.

Limited Engagement Agreement - The Limited Engagement cannot be paid to a student, an honoraria recipient, a human subject recipient, or any employee of the Trustees of the University of Pennsylvania or any of its entities. Only the Office of Corporate Tax, Compliance, and Payroll can make the determination if an individual is a limited engagement agreement. You must submit to Corporate Tax, Compliance, and Payroll for review and final determination via a BEN Helps Support Ticket, the Service Provider Questionnaire and Evaluation PRIOR to submitting an invoice for payment or supplier request.

Guest Travel Reimbursement and Honoraria requirements- Compensated individuals that are not employees and are identified as Independent Service Providers (ISPs) or Limited Engagement that receive “reimbursement” payments from Penn in connection with services provided should not use the Guest Travel Reimbursement (GTR) worksheet for any agreed upon expense reimbursements. These should be reflected within their fee structure. All such payments should be coded to the appropriate tax-reportable object codes and will be reported on their 1099.

Requestor First Name*

Requestor Last Name*

Requestor Phone Number*

Requestor Email*

Must be an email, i.e. xx@upenn.edu

Supervisor Email*

Department*

Assigned To*

Please choose the operations contact for your department.

Select

Transaction Request*

If you choose "unknown" you must put N/A for any field that is required but not a part of your request.

Select

Company Contact First Name*

Company Contact Last Name*

Email Address*

If paying a company, please include the Company Contact Email Address

Address*

If paying a company, please include the Company Contact Address

Location of Service*

Please provide the city and state at which the the individual is providing the service or performing their research.

Is this request for a supplier that will have direct access to Penn's sensitive or confidential data?*

The purpose of this risk assessment request is to help you make sure that any sensitive/confidential data shared with this supplier is protected properly to prevent a data breach or misuse of our data. Purchasing has established processes in place to help ensure a smooth and timely evaluation process with minimal disruption to the onboarding process once we understand the level of risk (Low, Medium or High). One of our most important assets on campus is our data – whether student, patient, faculty, staff or strategic operations. Your efforts here help make it safer for all of our data on campus. Thanks for your assistance.

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Is this request for an Independent Contractor*

Is this request for an Independent Contractor (an Individual/sole proprietor or single-member LLC providing services)? Independent contractor's W9/W8 - should be uploaded upon registration by the individual. An independent contractor is a payee providing services to the University who is not a Penn employee and whose legal structure is Individual/sole proprietor or single-member LLC. If classified as Limited Engagement on a Non PO Payee Request with a completed LE Agreement attached.

For more information please visit: https://www.hr.upenn.edu/policies-and-procedures/processes-and-procedures/service-provider-classification

Select

Is this request for a foreign supplier?*

Select

To the best of your knowledge, is the company controlled, or actively influenced (with regard to any proposed transaction with the University) by you, a member of your immediate family, or any employee, faculty member, trustee, member of a board of overseers of the University?*

Select

To the best of your knowledge, does this company employ in a sales capacity, you or a member of your immediate family, or any person who is a full-time, employee, faculty member, trustee, member of a board of overseers of the University?*

Select

Description of goods or services being requested.*

What Department are you transferring to?*

Please provide the account you want to TRANSFER TO*

What Department are you transferring from?*

Please provide the account to TRANSFER FROM*

Will the Supplier be used more than once?

Select

Student Penn ID*

Student Email*

Payee First Name*

If this a company, please provide the primary contact person.

Payee Last Name*

If this a company, please provide the primary contact person.

Is the Payee a Foreign National?*

Is this individual a Sole Proprietor, LLC?*

If YES, please fill out the Project Start/End Date. If NO, then you will need to attach a limited engagement form to this request (end of form).

Select

Company Name*

If this is a Sole Proprietor, LLC, please provide the name of the LLC.

Is payee already a Penn supplier?

Select

Name of individual to send onboarding invitation*

Email address to send onboarding invitation*

Payee Permanent Address*

Payee Phone Number*

Business Justification/Scope of Work*

Provide the reason for the request, with sufficient detail. Please answer the following questions with your Justification: Who, What, When, Where and Why?

Invoice, Quote/Estimate, or Order Number*

If the document you are attaching to this request references an invoice/quote/order/estimate document number (such as INV# 0001), please include that here. If not, please enter “N/A.”

Project Start Date*

Project End Date*

Payment Amount*

Event Date*

Competitive Bidding

Only required if payment will be in excess of $10,000 or above.

Select

Account for funding*

Please provide the budget account or description of where you would like the funding to come from, example: 000000 Fund, Specific Gift, Operational Fund, etc.

Attachments*

Please attach any quotes/invoices/contracts for signature/bid waivers, etc. that will assist in the process of your request. If you are requesting a payment for service to an individual, please attach the SPQ and SPE for the Individual Service Provider, including the determination by the Office of Corporate Tax and Compliance. If the determination was approved as Limited Engagement, you must attach a limited engagement form. If you are requesting a guest reimbursement, please attach both Payment Support (receipts) and a Guest Travel Reimbursement form as one scanned document. For an Honoraria, please attach an Event Flyer or equivalent documentation of the Event documenting person’s participation, date and location of activity or event. Also include the acknowledgment document (i.e. email) between the individual and department.

Workday Requests - Please attach any necessary forms for requests related to additional pays or acting rates (see top of submission form for links).

HOTEL AUTHORIZATION FORMS - Please attach the form for review and signature.

NOTE FOR FOREIGN INDIVIDUALS For activity inside the U.S. please attach a Stamp of Entry (I-94 Form). For foreign individuals and non-U.S. entities, please attach a Certificate of Foreign Income Form or Stamp of Entry (I-94) per the above instructions. Please redact any sensitive information before attaching the I-94 (passport and visa #’s). The Foreign National Information Form (FNIF) will be collected separately outside of the Penn Marketplace process.

Drag and drop files here or

Additional Notes

Please provide any additional information related to your request. Examples: Delivery to which location? Any questions you have?

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