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.
| Individual Disbursement Services |
| Form Name |
Format |
Comments |
| Travel and Entertainment Expense Report (C-1) |
PDF |
Revised 4/09 (revised form required 5/1/09) |
| Excel 97-2003* |
| Travel and Entertainment - Entertainment & Business Meal Worksheet(C-1A Form) |
PDF |
Revised 4/09 (revised form required 5/1/09) |
| Excel 97-2003* |
| Reimbursement Justification Form (C-5 Form)
|
PDF
|
Revised 4/09 (revised form required 5/1/09) |
| Word Doc |
| Travel and Entertainment Advance Request (C-7 Form) |
PDF |
Revised 4/09 (revised form required 5/1/09) |
| Word 97-2003* |
| Advance Justification Form (C-7A Form) |
PDF |
Revised 4/09 (revised form required 5/1/09)
Must accompany each Advance Request (C7) form |
Request for Payment C-368
(Payment/Reimbursements other than Travel) |
PDF* |
New form effective 11/1/2008 |
| Excel 97-2003* |
| Statement of Business Connection |
PDF |
|
| FNIF |
PDF |
Foreign National Information Form |
| Form SS-5 |
PDF |
Application for a Social Security Card |
| Form W-7 |
PDF |
Application for IRS Individual Taxpayer Identification Number |
| Form W-9 |
PDF |
Request for Taxpayer Identification Number and Certification |
| Honoraria Eligibility Certification Form |
PDF |
Foreign Visitors Honoraria Eligibility Certification Form |
| C-12 Independent Contractor Determination & Certification |
PDF |
|
| CFSI |
PDF |
Certification of Foreign Source Income |
| Payroll |
| Form Name |
Format |
Comments |
| 2009 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 |
| Tax Exemption Form |
PDF |
Application for Phila City Wage/PA State Taxpayer Exemption |
| 2009 Form W-5 |
PDF |
Earned Income Credit Advance Payment Certificate |
| Form I-9 |
PDF |
INS Employment Eligibility Verification |
| 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 97-2003 |
| Stop Payment Request Form |
PDF* |
|
| Word 97-2003* |
| Payroll Stale Dated Check Form |
PDF |
|
| Word 97-2003 |
| Hand Drawn Check Request Memo (Manual) |
PDF |
|
| Word 97-2003 |
| Additional Payment Form |
PDF* |
Additional Pay Worksheet |
| Word 97-2003* |
| Excel 97-2003 worksheet |
| Performance Bonus Pay Form |
PDF* |
Bonus Pay Worksheet |
| Word 97-2003* |
|
Excel 97-2003
worksheet |
| Vacation Payout at Separation Form |
PDF* |
|
| Word 97-2003* |
| Restricted Salary Reallocation Request |
PDF* |
|
| Excel 97-2003* |
| Wage & Tax Statement Information |
PDF |
W2 Address Change |
| Word 97-2003 |
| Request for Administrative Mainframe LOGON ID |
PDF* |
Access to Payroll, PennWorks, SAM, SFSEASI, SRS, TSO, Focus, Natural |
| MS Word* |
| WESD Proxy Security Request |
PDF* |
|
| Word 97-2003* |
| PennERS Access Request Form |
PDF* |
|
| Word 97-2003* |
| Employee Information Form |
PDF* |
|
| Word 97-2003* |
| Voluntary Self-Identification Form |
PDF |
|
| Temporary/Hourly Time Reporting Form |
Excel 97-2003 |
|
| PDF |
| Request for Overpayment Calculation |
Word 97-2003* |
|
| Required forms for Foreign National Students/Scholars |
Webpage |
Listing of Forms that are required for Nonresident Aliens |
| FNIF |
PDF |
Foreign National Information Form |
| City Wage Tax |
| 2009 Cover Letter |
PDF |
|
| Penn 2009 Philadelphia Petition Form |
Excel |
|
| Penn 2009 Philadelphia Petition Instructions |
PDF |
|
| Statement Instructions |
PDF |
|
| CLINICAL PRACTICES ONLY - PAYROLL ADMINISTRATORS |
| Additional Pay for CPUP/CHOPPA Clinical Physician Practices Form |
PDF* |
Directions included |
| Word 97-2003* |
| CPUP/CHOPPA Pension Adjustment Compensation Form |
PDF |
Directions included |
| Excel 97-2003* |
| CPUP/CHOPPA Tax Adjustment Form |
PDF |
Directions included |
| Excel 97-2003* |
