University of Pennsylvania
Comptroller's Office
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Comptroller's Office
University of Pennsylvania
Suite 312 Franklin Building
3451 Walnut Street
Philadelphia, PA 19104
215.898.7593 (Phone)
215.898.0817 (Fax)

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Office of the Comptroller

[ Document/Forms ]

The following forms are available to download in Word, Excel or PDF formats. Unless specified the forms will be downloaded to the web browser's default directory.

Contact your local desktop support provider for assistance with obtaining and installing the Acrobat Reader for opening PDF forms and documents.

* Forms marked with an asterisk (*) are available to fill out on-line. Once filled out please print out the form and sign, if necessary, before forwarding them to the appropriate office. All other forms downloaded may be filled in neatly by hand or type.

Accounts Payable
Form Name Format Comments
Check Cancel/Stop Payment Request PDF  
Word 97-2002*
Word 95*
Request for Payment C-368
(Single Distribution)
PDF* Click here for information on Direct Deposit for reimbursements
Word 97-2002*
Excel 97-2002*
Request for Payment C-368
(Multiple Distribution)
PDF Click here for information on Direct Deposit for reimbursements
Word 97-2002*
Excel 97-2002*
Request for Payment C-368
(Foreign Drafts)
PDF Click here for information on Direct Deposit for reimbursements
Excel 97-2002*
Request for Payment C-368
(via Wire Transfer)
Word 97-2002*  
Request for Payment Subject List PDF  
Word 97-2002*
Request for Reimbursement of Petty Cash Fund PDF*  
Word 97-2002*
Word 95*

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BEN
Form Name Format Comments
BEN Deposits
BEN Deposits Access Request Form PDF  
Word 97-2002
BEN Financials
Planning Access Request Form PDF  
Prudence Access Request Form PDF  
BEN Financials Printer Registration Form PDF  
Word 97-2002*
Application Logon ID Request Form MS Word  
PDF
BEN Appl Log in ID/Name Change Request PDF*  
Word 97-2002*
DW Appl Login ID/Name Change Request PDF*  
Word 97-2002*
Financial Training Registration Refer to the Registration section of the Financial Training website.
Enhancement Request Form PDF  
GL Feeder Request Form PDF  
Word 97-2002*
BEN Reports
BEN Reports Access Request Form PDF  

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Corporate Tax
Form Name Format Comments
Required forms for Foreign National Students/Scholars Webpage Listing of Forms that are required for Nonresident Aliens
Statement of Business Connection PDF
FNIF PDF Foreign National Information Form
Form SS-5 PDF Application for a Social Security Card
2008 Form W-4 PDF Employee's Withholding Allowance Certificate
Form W-4 (New Jersey) PDF Employee's Withholding Allowance Certificate for State of New Jersey
Form DE4 (California) PDF CA Withholding Allowance Certificate
Form W-7 PDF Application for IRS Individual Taxpayer Identification Number
Tax Exemption Form PDF Application for Phila City Wage/PA State Taxpayer Exemption
Form W-9 PDF Request for Taxpayer Identification Number and Certification
2008 Form W-5 PDF Earned Income Credit Advance Payment Certificate
Form I-9 PDF INS Employment Eligibility Verification
Honoraria Eligibility Certification Form PDF Foreign Visitors Honoraria Eligibility Certification Form
C-12 Independent Contractor Determination & Certification PDF  
Graduate Student and Post Doctoral Appointment Information Form PDF You may also find the Definitions of FULL-TIME Graduate Student Appointment page helpful.
Word 95
Word 97-2002
CFSI PDF Certification of Foreign Source Income
Sales Tax Templates and Matrices
Alabama Excel
Arizona Excel
California Excel
Colorado Excel
Connecticut Excel
Florida Excel
Georgia Excel
Hawaii Excel
Idaho Excel
Illinios Excel
Indiana Excel
Iowa Excel
Kansas Excel
Louisiana Excel
Maine Excel
Maryland Excel
Massachusetts Excel
Minnesota Excel
Missouri Excel
New Jersey Excel
North Carolina Excel
New York Excel
Oklahoma Excel
Pennsylvania Excel
South Carolina Excel
Texas Excel
Utah Excel
Vermont Excel
Virginia Excel
Pennsylvania Matrices
Construction Excel/Word Penn Key and Password required
Master Excel Penn Key and Password required
Schools / Centers Excel Penn Key and Password required
Contact Joe Gibbs if you have any questions about the Appendicies and Matrices
joegibbs@pobox.upenn.edu           (215)898-1552

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General Accounting/Budget Office
Form Name Format Comments
New FUND Request Form PDF*  
Word 97-2002*
Word 95*
Transaction Authorization Card Request PDF  
Word 97-2002*
Word95*
Request to Create/Change Organization (ORG) PDF  
Word 97-2002
Request to Create/Change Program (Prog) PDF  
Word 97-2002

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ISC Systems Access Forms
Form Name Format Comments
ACF2 Rule Request MS Word  
PDF
Administrative Mainframe Logon ID MS Word  
PDF
AIX script/software move MS Word  
PDF
ISC SEO Server and WFR Request Form MS Word  
PDF
Remedy Door Access MS Word  
PDF

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Payroll
Form Name Format Comments
2008 W-4 PDF Employee's Withholding Allowance Certificate
Stop Payment Request Form PDF*  
Word 97-2002*
Payroll Stale Dated Check Form PDF  
Word 97-2002
Hand Drawn Check Request Memo (Manual) PDF  
Word 97-2002
Additional Payment Form PDF*  

Additional Pay Worksheet

Word 97-2002*
Excel worksheet
Performance Bonus Pay Form PDF*  

Bonus Pay Worksheet

Word 97-2002*
Excel worksheet
Vacation Payout at Separation Form PDF*  
Word 97-2002*
Restricted Salary Reallocation Request PDF*  
Excel 97-2002*
Wage & Tax Statement Information PDF W2 Address Change
Word 97-2002
Request for Administrative Mainframe LOGON ID PDF*  
MS Word*
WESD Proxy Security Request PDF*  
Word 97-2002*
PennERS Access Request Form PDF*  
Word 97-2002*
Employee Information Form PDF*  
Word 97-2002*
Voluntary Self-Identification Form PDF  
Temporary/Hourly Time Reporting Form Excel 97-2002  
Request for Overpayment Calculation Word 97-2002*  
CLINICAL PRACTICES ONLY - PAYROLL ADMINISTRATORS
Additional Pay for CPUP/CHOPPA Clinical Physician Practices Form PDF* Directions included
Word 97-2002*
CPUP/CHOPPA Pension Adjustment Compensation Form PDF Directions included
Excel 97-2002*
CPUP/CHOPPA Tax Adjustment Form PDF Directions included
Excel 97-2002*

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Purchasing Card
Form Name Format Comments
Purchasing Card Application PDF Instructions, Cardholder Account Form, Cardholder Agreement, and Usage Guidelines.
Word 97-2002
Purchasing Card Roles PDF
Word 97-2002
Fleet Card Application PDF
Word 97-2002
Delete Cardholder Account Form PDF To be completed to delete a cardholder's account.
Word 97-2002
Gift and Endowment Certification Letter
PDF  

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Property Management
Form Name Format Comments
Equipment Change Form PDF To be completed when transferring ownership of equipment between schools/centers.
Word 97-2002
Authorization for Retirement of Equipment PDF To be completed for property items that will be disposed of.
Word 97-2002
Home and Remote Location Form PDF To be completed for University-Owned Property items that will be used at home.
Word 97-2002
Equipment Information Form PDF* To be completed by the school/center when assets are created in BEN Assets by PMG based Journal Entries and Cash Deposits or for setting up new Equipment in Process Assets.
Word 97-2002*

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Travel
Form Name Format Comments
Travel and Entertainment Expense Report (C-1 & C-1A Forms) PDF Click here for information on Direct Deposit for reimbursements
Excel 97-2002*
Travel and Entertainment Advance Request (C-7 Form) PDF * NEW FORMAT 10/1/06
Word 97-2002*
Confidential Traveler Profile PDF  
Word 97-2002*
Word 95*
American Express Corporate Card Application PDF For the University of Pennsylvania
Inn at Penn Authorization PDF  
Word 97-2002*
Sheraton University City Authorization PDF  
Word 97-2002*
Penn Tower Hotel Authorization PDF  
Word 97-2002*
Word 95*
campus

Comptroller Spotlights

New Category Codes
2007 Financial Report
GL Object Codes FY09
FY08 Closing Instructions

Comptroller Offices

Accounting
Accounts Payable
BEN
Corporate Tax
Payroll
Travel
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